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Mondoni M, Cefalo J, Carlucci P, Puci M, Saderi L, Degrassi M, Torrego Fernandez A, Pajares V, Bodtger U, Sorino C, Zagaria MP, Solidoro P, Centanni S, Sotgiu G. The current practice in the diagnostic work-up of patients with hemoptysis of unknown etiology: an international survey. Minerva Med 2024; 115:293-300. [PMID: 38695633 DOI: 10.23736/s0026-4806.24.09192-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
BACKGROUND Hemoptysis is a challenging and potentially life-threatening medical condition. The most appropriate diagnostic work-up is debated and several diagnostic approaches are implemented worldwide. METHODS An international, online survey was carried out to investigate the current practice of the diagnostic work-up of patients with hemoptysis of unknown etiology. RESULTS Overall, 604 physicians responded to the survey. At baseline, chest X-ray was suggested as the first diagnostic investigation by 342 (56.6%) participants. Computed tomography (CT) was suggested in each patient with non- and life-threatening hemoptysis by 310 (51.3%) and 526 (87.1%) respondents, respectively. Contrast-enhanced CT is the currently preferred technique (333, 55.1%). In case of patchy ground glass opacities and negative CT, 287 (47.5%) and 222 (36.8%) participants, respectively, would always offer bronchoscopy. Otorhinolaryngological evaluation was mostly suggested in case of suspected upper airways bleeding before other investigations (212, 35.1%). A follow-up was recommended for idiopathic hemoptysis by the majority of the participants (316, 52.3%). A multidisciplinary assessment is deemed crucial for each patient with life-threatening hemoptysis (437, 72.4%). CONCLUSIONS Chest X-ray and contrast-enhanced CT are currently preferred as the first diagnostic investigations, regardless of hemoptysis severity. Bronchoscopy is suggested in case of negative radiological examination and when CT shows only ground glass opacities. Otorhinolaryngological evaluation is advised before any other investigations when upper airways bleeding is suspected. Patients with idiopathic hemoptysis are suggested to undergo a clinical follow-up and in case of life-threatening bleeding a multidisciplinary assessment is deemed crucial. Due to the heterogeneous approaches a consensus statement would be needed.
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Affiliation(s)
- Michele Mondoni
- Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy -
| | - Jacopo Cefalo
- Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Paolo Carlucci
- Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Mariangela Puci
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Mauro Degrassi
- Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | | | - Virginia Pajares
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Uffe Bodtger
- Department of Respiratory Medicine, Zealand University Hospital, Roskilde/Næstved, Denmark
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Claudio Sorino
- Division of Pulmonology, Sant'Anna Hospital of Como, University of Insubria, Varese, Italy
| | - Maria P Zagaria
- Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Paolo Solidoro
- Division of Respiratory Medicine, Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza di Torino, Turin, Italy
- Medical Sciences Department, University of Turin, Turin, Italy
| | - Stefano Centanni
- Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Singer ED, Faiz SA, Qdaisat A, Abdeldaem K, Dagher J, Chaftari P, Yeung SCJ. Hemoptysis in Cancer Patients. Cancers (Basel) 2023; 15:4765. [PMID: 37835458 PMCID: PMC10571539 DOI: 10.3390/cancers15194765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/22/2023] [Accepted: 09/24/2023] [Indexed: 10/15/2023] Open
Abstract
Hemoptysis in cancer patients can occur for various reasons, including infections, tumors, blood vessel abnormalities and inflammatory conditions. The degree of hemoptysis is commonly classified according to the quantity of blood expelled. However, volume-based definitions may not accurately reflect the clinical impact of bleeding. This review explores a more comprehensive approach to evaluating hemoptysis by considering its risk factors, epidemiology and clinical consequences. In particular, this review provides insight into the risk factors, identifies mortality rates associated with hemoptysis in cancer patients and highlights the need for developing a mortality prediction score specific for cancer patients. The use of hemoptysis-related variables may help stratify patients into risk categories; optimize the control of bleeding with critical care; implement the use of tracheobronchial or vascular interventions; and aid in treatment planning. Effective management of hemoptysis in cancer patients must address the underlying cause while also providing supportive care to improve patients' quality of life.
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Affiliation(s)
- Emad D. Singer
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (E.D.S.); (A.Q.); (K.A.)
- Department of Abdominal Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Saadia A. Faiz
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Aiham Qdaisat
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (E.D.S.); (A.Q.); (K.A.)
| | - Karim Abdeldaem
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (E.D.S.); (A.Q.); (K.A.)
| | - Jim Dagher
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut 1100, Lebanon
| | - Patrick Chaftari
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (E.D.S.); (A.Q.); (K.A.)
| | - Sai-Ching J. Yeung
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (E.D.S.); (A.Q.); (K.A.)
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3
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Singhal R, K.B SB, Naranje P, Kazimi J, Garg PK, Chandra D, Popat BA, Shetty NS, Gorsi U, Vimala LR, Khera PS, Irodi A, Kulkarni S, Keshava SN, Bhalla AS. Society of Chest Imaging and Interventions Consensus Guidelines for the Interventional Radiology Management of Hemoptysis. Indian J Radiol Imaging 2023; 33:361-372. [PMID: 37362365 PMCID: PMC10289864 DOI: 10.1055/s-0043-1762552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
The recommendations from the Society of Chest Imaging and Interventions expert group comprehensively cover all the aspects of management of hemoptysis, highlighting the role of diagnostic and interventional radiology. The diversity existing in etiopathology, imaging findings, and management of hemoptysis has been addressed. The management algorithm recommends the options for effective treatment while minimizing the chances of recurrence, based on the best evidence available and opinion from the experts.
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Affiliation(s)
- Rajat Singhal
- Department of Interventional Radiology, Division of Clinical Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santhosh Babu K.B
- Department of Interventional Radiology, Division of Clinical Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Priyanka Naranje
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Junaid Kazimi
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Pawan K. Garg
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India
| | - Daksh Chandra
- Interventional Radiology Department, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Bhavesh A. Popat
- Department of Interventional Radiology, Hinduja Hospital, Mumbai, Maharashtra, India
- Department of Interventional Radiology, Breach Candy Hospital, Mumbai, Maharashtra, India
- Department of Interventional Radiology, Saifee Hospital, Mumbai, Maharashtra, India
| | - Nitin S. Shetty
- Interventional Radiology Department, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Ujjwal Gorsi
- Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Leena Robinson Vimala
- Department of Radiodiagnosis, Division of Clinical Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pushpinder S. Khera
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India
| | - Aparna Irodi
- Department of Radiodiagnosis, Division of Clinical Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suyash Kulkarni
- Interventional Radiology Department, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Shyamkumar N. Keshava
- Department of Interventional Radiology, Division of Clinical Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ashu S. Bhalla
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
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Mondoni M, Rinaldo RF, Solidoro P, Di Marco F, Patrucco F, Pavesi S, Baccelli A, Carlucci P, Radovanovic D, Santus P, Raimondi F, Vedovati S, Morlacchi LC, Blasi F, Sotgiu G, Centanni S. Interventional pulmonology techniques in lung transplantation. Respir Med 2023; 211:107212. [PMID: 36931574 DOI: 10.1016/j.rmed.2023.107212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/04/2023] [Accepted: 03/12/2023] [Indexed: 03/19/2023]
Abstract
Lung transplantation is a key therapeutic option for several end-stage lung diseases. Interventional pulmonology techniques, mostly bronchoscopy, play a key role throughout the whole path of lung transplantation, from donor evaluation to diagnosis and management of post-transplant complications. We carried out a non-systematic, narrative literature review aimed at describing the main indications, contraindications, performance characteristics and safety profile of interventional pulmonology techniques in the context of lung transplantation. We highlighted the role of bronchoscopy during donor evaluation and described the debated role of surveillance bronchoscopy (with bronchoalveolar lavage and transbronchial biopsy) to detect early rejection, infections and airways complications. The conventional (transbronchial forceps biopsy) and the new techniques (i.e. cryobiopsy, biopsy molecular assessment, probe-based confocal laser endomicroscopy) can detect and grade rejection. Several endoscopic techniques (e.g. balloon dilations, stent placement, ablative techniques) are employed in the management of airways complications (ischemia and necrosis, dehiscence, stenosis and malacia). First line pleural interventions (i.e. thoracentesis, chest tube insertion, indwelling pleural catheters) may be useful in the context of early and late pleural complications occurring after lung transplantation. High quality studies are advocated to define endoscopic standard protocols and thus help improving long-term prognostic outcomes of lung transplant recipients.
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Affiliation(s)
- Michele Mondoni
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
| | - Rocco Francesco Rinaldo
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Paolo Solidoro
- S.C. Pneumologia, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Fabiano Di Marco
- Pulmonary Medicine Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy; Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Filippo Patrucco
- Respiratory Diseases Unit, Medical Department, AOU Maggiore della Carità, Novara, Italy
| | - Stefano Pavesi
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Andrea Baccelli
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Paolo Carlucci
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Dejan Radovanovic
- Division of Respiratory Diseases, Ospedale Luigi Sacco, Polo Universitario, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano, Milano, Italy
| | - Pierachille Santus
- Division of Respiratory Diseases, Ospedale Luigi Sacco, Polo Universitario, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano, Milano, Italy
| | | | - Sergio Vedovati
- Pediatric Intensive Care Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Francesco Blasi
- Respiratory Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Department Pathophysiology and Trasplantation, Università degli studi di Milano, Milano, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical, Experimental Sciences, University of Sassari, Sassari, Italy
| | - Stefano Centanni
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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5
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Wu X, Lin R, Ding D, Ding X, Fan Z, Wang T, Chen G, Sun Y, Lin Y, Wang H, Yin M, Yan Y. Global Trends Of The Researches On Ossification Of Posterior Longitudinal Ligament In Thoracic Spine: A Bibliometric And Visualization Study. World Neurosurg 2022; 168:e1-e11. [PMID: 35817352 DOI: 10.1016/j.wneu.2022.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/04/2022] [Indexed: 11/18/2022]
Abstract
STUDY DESIGN Bibliometric analysis OBJECTIVE: Thoracic ossification of the posterior longitudinal ligament (TOPLL) was a rare but intractable disease, and was the second leading cause of thoracic myelopathy. This study aimed to illustrate the overall knowledge structure, and development trends of TOPLL, using a bibliometric analysis and newly developed visualization tools. METHODS Research datasets were acquired from the Web of Science. The literature search was also limited to articles that were published until Oct 30, 2021. VOS viewer and Citespace software was provided to analyze the data and generate visualization knowledge maps. Annual trend of publications, distribution, H-Index status, co-authorship status and research hotspots were analyzed. RESULTS 206 publications met the requirement. Japan published most papers (92), both total citations (1574) and H-index (24) ranked first of all the countries. The most productive organizations were Peking University (22). The most productive authors were Yamazaki M (18). The most productive journals were Spine (33). Diagnosis and treatment on the accuracy of surgical segments, prognosis of patients, and gene research were the research hotspots in the recent years. CONCLUSION The study showed an upward trend with a stable rise in recent years. Japan is country with the highest productivity, not only in quality, but also in quantity. Peking University and Spine have been the largest contributor. Indeed, this study provides great insights to the growth and development of TOPLL. Moreover, it will contribute to the growth of the international frontier.
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Affiliation(s)
- Xifa Wu
- Department of Spine, Shandong Zibo Central Hospital, Shandong, China
| | - Rui Lin
- Department of Spine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Ding Ding
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xing Ding
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhaoxiang Fan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tao Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guanghui Chen
- Department of Orthopaedics, Third Affiliated Hospital of Peking University, Beijing, China
| | - Yueli Sun
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yongpeng Lin
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Hongshen Wang
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Mengchen Yin
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yinjie Yan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Luo L, Luo J, Jiang Y. A retrospective analysis of risk factors for massive hemoptysis in patients with bronchiectasis. BMC Pulm Med 2022; 22:214. [PMID: 35650568 PMCID: PMC9161452 DOI: 10.1186/s12890-022-02006-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Massive hemoptysis is a common and fatal complication of bronchiectasis. However, the risk factors for massive hemoptysis in patients with bronchiectasis have not yet been reported. This study investigated the potential risk factors for massive hemoptysis in patients with bronchiectasis. METHODS This retrospective study included patients with bronchiectasis and their data were obtained from medical records. The risk factors for massive hemoptysis were evaluated by multivariate analysis of patient characteristics, medical history, and computed tomography imaging data, including the number of lesions, lesion location, and laboratory findings. RESULTS Among 379 patients, 61 (16.09%) experienced severe hemoptysis. Multivariate analysis revealed that diabetes (odds ratio (OR) 2.885; 95% confidence interval (CI) 1.009-8.247), lesions involving two lobes (OR 4.347; 95% CI 1.960-9.638) and three lobes (OR 2.787; 95% CI 1.055-7.363) were significant predictors of severe hemoptysis. However, a disease course between 1 and 5 years (OR 0.300; 95% CI 0.112-0.801) and involvement of the left lower lobe (OR 0.394; 95% CI 0.196-0.793) were protective factors for the prevention of massive hemoptysis. Lesions in the right upper lobe were more likely to cause massive hemoptysis (OR 1.458) than involvement of other lobes. CONCLUSIONS Diabetes and lesions involving two and three lobes, were risk factors for massive hemoptysis in patients with bronchiectasis. Disease duration between 1 and 5 years and involvement of the left lower lobe were protective factors, while lesions in the right upper lobe had a stronger relationship with massive hemoptysis in patients with bronchiectasis.
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Affiliation(s)
- Ling Luo
- Department of Respiratory and Critical Medicine, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, China
| | - Jing Luo
- Department of Respiratory and Critical Medicine, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, China
| | - Yu Jiang
- Department of Respiratory and Critical Medicine, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, China.
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7
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Ding X, Yan M, Wu J, Xu C, Yan Y, Yu Z, Yin M, Xu J, Ma J, Mo W. Top 50 Most Cited Articles on Thoracic Ossification of Posterior Longitudinal Ligament. Front Surg 2022; 9:868706. [PMID: 35615648 PMCID: PMC9126040 DOI: 10.3389/fsurg.2022.868706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
Study DesignBibliometric analysis.ObjectiveOver the last several decades, the field of thoracic ossification of the posterior longitudinal ligament (T-OPLL) has evolved unprecedentedly, and the literature on T-OPLL has increased significantly. The purpose of this study is to identify and review the top 50 most cited publications related to T-OPLL.MethodsThe most frequently cited 50 articles in this field until 30 October 2021 were identified by searching Web of Science. We ranked the articles based on the citation number. Through the bibliometric method, we evaluated the following information: article title, first author, year of publication, journal of publication, total number of citations, country, and study topic.ResultsThe number of citations of included studies ranged from 20 to 108, with a mean number of 45.4. The journal Spine published most articles (20), followed by Spinal Cord (5), and European Spine (5). All of these articles were contributed by 38 first authors, Yamazaki (4), Fujimura (3), and Aizawa (3) who published more than 2 articles. In the respect of productive countries, Japan (39) contributed most papers. Tomita contributed the most cited article in 1990 on Spine, which was the first-ever report of circumferential decompression for thoracic myelopathy due to T-OPLL.ConclusionThe top 50 influential articles on T-OPLL were identified and analyzed in this study. It will undoubtedly provide a comprehensive and detailed basis for the orthopedic and neurosurgery physicians to make a clinical decision and assimilate the research focus of spine surgery.
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Menditto VG, Mei F, Fabrizzi B, Bonifazi M. Role of bronchoscopy in critically ill patients managed in intermediate care units - indications and complications: A narrative review. World J Crit Care Med 2021; 10:334-344. [PMID: 34888159 PMCID: PMC8613715 DOI: 10.5492/wjccm.v10.i6.334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/18/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
Flexible bronchoscopy (FB) has become a standard of care for the triad of inspection, sampling, and treatment in critical care patients. It is an invaluable tool for diagnostic and therapeutic purposes in critically ill patients in intensive care unit (ICU). Less is known about its role outside the ICU, particularly in the intermediate care unit (IMCU), a specialized environment, where an intermediate grade of intensive care and monitoring between standard care unit and ICU is provided. In the IMCU, the leading indications for a diagnostic work-up are: To visualize airway system/obstructions, perform investigations to detect respiratory infections, and identify potential sources of hemoptysis. The main procedures for therapeutic purposes are secretion aspiration, mucus plug removal to solve atelectasis (total or lobar), and blood aspiration during hemoptysis. The decision to perform FB might depend on the balance between potential benefits and risks due to frailty of critically ill patients. Serious adverse events related to FB are relatively uncommon, but they may be due to lack of expertise or appropriate precautions. Finally, nowadays, during dramatic recent coronavirus disease 2019 (COVID-19) pandemic, the exact role of FB in COVID-19 patients admitted to IMCU has yet to be clearly defined. Hence, we provide a concise review on the role of FB in an IMCU setting, focusing on its indications, technical aspects and complications.
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Affiliation(s)
- Vincenzo G Menditto
- Department of Emergency Medicine, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona 60126, Italy
| | - Federico Mei
- Respiratory Diseases Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona 60126, Italy
| | - Benedetta Fabrizzi
- Cystic Fibrosis Regional Reference Center, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona 60126, Italy
| | - Martina Bonifazi
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona 60126, Italy
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9
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Mondoni M, Carlucci P, Cipolla G, Pagani M, Tursi F, Fois A, Pirina P, Canu S, Gasparini S, Bonifazi M, Marani S, Comel A, Saderi L, De Pascalis S, Alfano F, Centanni S, Sotgiu G. Long-term prognostic outcomes in patients with haemoptysis. Respir Res 2021; 22:219. [PMID: 34348724 PMCID: PMC8336236 DOI: 10.1186/s12931-021-01809-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/23/2021] [Indexed: 11/21/2022] Open
Abstract
Background Haemoptysis is a challenging symptom that can be associated with potentially life-threatening medical conditions. Follow-up is key in these patients to promptly detect new or misdiagnosed pathologic findings. Few prospective studies have evaluated long-term prognostic outcomes in patients with haemoptysis. Furthermore, the role played by antiplatelet and anticoagulant drugs on mortality and recurrence rates is unclear. The aim of this study was to assess mortality after 18 months of follow-up. Furthermore, the incidence of recurrence and the risk factors for recurrence and death were evaluated (including the role played by anticoagulant and antiplatelet drugs). Methods Observational, prospective, multicentre, Italian study. Results 451/606 (74.4%) recruited patients with haemoptysis completed the 18 months follow-up. 22/604 (3.6%) diagnoses changed from baseline to the end of the follow-up. 83/604 (13.7%) patients died. In 52/83 (62.7%) patients, death was the outcome of the disease which caused haemoptysis at baseline. Only the diagnosis of lung neoplasm was associated with death (OR (95%CI): 38.2 (4.2–347.5); p-value: 0.0001). 166 recurrences were recorded in 103/604 (17%) patients. The diagnosis of bronchiectasis was significantly associated with the occurrence of a recurrence (OR (95% CI): 2.6 (1.5–4.3)); p-value < 0.0001). Anticoagulant, antiaggregant, and anticoagulant plus antiaggregant drugs were not associated with an increased risk of death and recurrence. Conclusions Our study showed a low mortality rate in patients with haemoptysis followed-up for 18 months. Pulmonary malignancy was the main aetiology and the main predictor of death, whereas bronchiectasis was the most frequent diagnosis associated with recurrence. Antiplatelet and/or anticoagulant therapy did not change the risk of death or recurrence. Follow-up is recommended in patients initially diagnosed with lower airways infections and idiopathic bleeding. Trial registration: NCT02045394
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Affiliation(s)
- Michele Mondoni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Via A. Di Rudinì n.8, 20142, Milan, Italy.
| | - Paolo Carlucci
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Via A. Di Rudinì n.8, 20142, Milan, Italy
| | | | - Matteo Pagani
- UO Pneumologia ed Endoscopia Toracica, Azienda Ospedaliero Universitaria di Parma, Parma, Italy
| | - Francesco Tursi
- UOS Servizio Pneumologia, Ospedale di Codogno, ASST Lodi, Codogno (Lodi), Italy
| | - Alessandro Fois
- Lung Disease Unit, Dept of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Pietro Pirina
- Lung Disease Unit, Dept of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Sara Canu
- Lung Disease Unit, Dept of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Stefano Gasparini
- Pulmonary Disease Unit, Department of Internal Medicine, Azienda Ospedali Riuniti, Department of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Ancona, Italy
| | - Martina Bonifazi
- Pulmonary Disease Unit, Department of Internal Medicine, Azienda Ospedali Riuniti, Department of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Ancona, Italy
| | - Silvia Marani
- UO Medicina Interna, AUSL Modena, Ospedale di Carpi, Carpi (Modena), Italy
| | - Andrea Comel
- UO Pneumologia, Ospedale P. Pederzoli, Peschiera del Garda (Verona), Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Dept of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Sabrina De Pascalis
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Via A. Di Rudinì n.8, 20142, Milan, Italy
| | - Fausta Alfano
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Via A. Di Rudinì n.8, 20142, Milan, Italy
| | - Stefano Centanni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Via A. Di Rudinì n.8, 20142, Milan, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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10
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Atchinson PRA, Hatton CJ, Roginski MA, Backer ED, Long B, Lentz SA. The emergency department evaluation and management of massive hemoptysis. Am J Emerg Med 2021; 50:148-155. [PMID: 34365064 DOI: 10.1016/j.ajem.2021.07.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/09/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Massive hemoptysis is a life-threatening emergency that requires rapid evaluation and management. Recognition of this deadly condition, knowledge of the initial resuscitation and diagnostic evaluation, and communication with consultants capable of definitive management are key to successful treatment. OBJECTIVE The objective of this narrative review is to provide an evidence-based review on the management of massive hemoptysis for the emergency clinician. DISCUSSION Rapid diagnosis and management of life-threatening hemoptysis is key to patient survival. The majority of cases arise from the bronchial arterial system, which is under systemic blood pressure. Initial management includes patient and airway stabilization, reversal of coagulopathy, and identification of the source of bleeding using computed tomography angiogram. Bronchial artery embolization with interventional radiology has become the mainstay of treatment; however, unstable patients may require advanced bronchoscopic procedures to treat or temporize while additional information and treatment can be directed at the underlying pathology. CONCLUSION Massive hemoptysis is a life-threatening condition that emergency clinicians must be prepared to manage. Emergency clinicians should focus their management on immediate resuscitation, airway preservation often including intubation and isolation of the non-bleeding lung, and coordination of definitive management with available consultants including interventional radiology, interventional pulmonology, and thoracic surgery.
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Affiliation(s)
- Patricia Ruth A Atchinson
- Department of Emergency Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America
| | - Colman J Hatton
- Dartmouth-Hitchcock Medical Center, Section of Critical Care Medicine, Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America
| | - Matthew A Roginski
- Department of Emergency Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America
| | - Elliot D Backer
- Dartmouth-Hitchcock Medical Center, Section of Critical Care Medicine, Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America
| | - Brit Long
- Department of Emergency Medicine, Brooke Army Medical Center, San Antonio, TX, United States of America
| | - Skyler A Lentz
- Division of Emergency Medicine and Pulmonary Disease and Critical Care Medicine, The University of Vermont Larner College of Medicine, Burlington, VT, United States of America.
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11
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Duesberg CB, Valtin C, Fuge J, Logemann F, Fuehner T, Welte T, Gottlieb J. A Before-and-After Study of Evidence-Based Recommendations for On-Call Bronchoscopy. Respiration 2021; 100:600-610. [PMID: 33849036 DOI: 10.1159/000515134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/05/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Bronchoscopy is widely used and regarded as standard of care in most intensive care units (ICUs). Data concerning recommendations for on-call bronchoscopy are lacking. OBJECTIVES Evaluation of recommendations, complications, and outcome of on-call bronchoscopies. METHOD A retrospective single-centre analysis was conducted in a large university hospital. All on-call bronchoscopies performed outside normal working hours in the year before (period 1) and after (period 2) establishing a catalogue of recommendations for indications of on-call bronchoscopy on November 1, 2016, were included. RESULTS Overall, 924 bronchoscopies in 538 patients were analysed. A relative reduction of 83.6% from 794 bronchoscopies in 432 patients (1.84 per patient) during period 1 to 130 in 107 patients (1.21 per patient) during period 2 was observed. Most bronchoscopies (812/924, 87.9%) were performed in ICUs, and 416 patients (77.3%) were intubated. Bronchoscopies for excessive secretions decreased significantly during period 2. Fifty-three of 130 bronchoscopies (40.8%) fulfilled the specified recommendations during period 2, in comparison with 16.8% in period 1 (p < 0.001). Complications were recorded in 58 of 924 procedures (6.3%) and were more frequent in period 2, especially moderate bleeding. In-hospital mortality of patients undergoing on-call bronchoscopy did not differ between periods and was 28.7 and 30.2% in periods 1 and 2, respectively. CONCLUSION The introduction of recommendations for on-call bronchoscopy led to a significant decline of on-call bronchoscopies without negatively affecting outcome. More evidence is needed in on-call bronchoscopy, especially for ICU patients with intrinsic higher complication rates.
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Affiliation(s)
| | - Christina Valtin
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Jan Fuge
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,German Center for Lung Research (DZL), Hannover, Germany
| | - Frank Logemann
- Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany
| | - Thomas Fuehner
- German Center for Lung Research (DZL), Hannover, Germany.,Department of Respiratory and Intensive Care Medicine, Hospital Siloah, Hannover, Germany
| | - Tobias Welte
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,German Center for Lung Research (DZL), Hannover, Germany
| | - Jens Gottlieb
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,German Center for Lung Research (DZL), Hannover, Germany
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12
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Park HJ, Park SH, Woo UT, Cho SY, Jeon WJ, Shin WJ. Unilateral pulmonary hemorrhage caused by negative pressure pulmonary edema: A case report. World J Clin Cases 2021; 9:1408-1415. [PMID: 33644209 PMCID: PMC7896690 DOI: 10.12998/wjcc.v9.i6.1408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/28/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Unilateral pulmonary hemorrhage is typically reported in young and healthy men with upper respiratory tract obstruction during anesthesia in special situations. Negative pressure in the lungs is created, resulting in negative pressure pulmonary edema (NPPE).
CASE SUMMARY A 78-year-old male patient diagnosed with spinal stenosis was admitted to receive a unilateral laminectomy with bilateral decompression. The patient had been diagnosed with hypertension four years earlier and asthma more than 70 years earlier. We experienced a unilateral alveolar hemorrhage associated with NPPE that occurred in a longstanding asthma patient who bit the intubated endotracheal tube for a short period during posture change at the end of surgery. Because diffuse alveolar hemorrhage accompanied by NPPE was caused in this case by airway obstruction in an older patient with asthma without known risk factors, anesthesiologists should be careful not to induce airway irritation during anesthesia awakening in asthma patients.
CONCLUSION Because diffuse alveolar hemorrhage accompanied by NPPE can occur, anesthesiologists should take care not to induce airway irritation.
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Affiliation(s)
- Hyung Joon Park
- Department of Anesthesia and Pain Medicine, Hanyang University, Guri Hospital, Guri 11923, Gyeonggi-do, South Korea
| | - Seung Ho Park
- Department of Anesthesia and Pain Medicine, Hanyang University, Guri Hospital, Guri 11923, Gyeonggi-do, South Korea
| | - Un Tak Woo
- Department of Anesthesia and Pain Medicine, Hanyang University, Guri Hospital, Guri 11923, Gyeonggi-do, South Korea
| | - Sang Yun Cho
- Department of Anesthesia and Pain Medicine, Hanyang University, Guri Hospital, Guri 11923, Gyeonggi-do, South Korea
| | - Woo Jae Jeon
- Department of Anesthesia and Pain Medicine, Hanyang University, Guri Hospital, Guri 11923, Gyeonggi-do, South Korea
| | - Woo Jong Shin
- Department of Anesthesia and Pain Medicine, Hanyang University, Guri Hospital, Guri 11923, Gyeonggi-do, South Korea
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14
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Mondoni M, Sferrazza Papa GF, Rinaldo R, Faverio P, Marruchella A, D'Arcangelo F, Pesci A, Pasini S, Henchi S, Cipolla G, Tarantini F, Giuliani L, Di Marco F, Saracino L, Tomaselli S, Corsico A, Gasparini S, Bonifazi M, Zuccatosta L, Saderi L, Pellegrino G, Davì M, Carlucci P, Centanni S, Sotgiu G. Utility and safety of bronchoscopy during the SARS-CoV-2 outbreak in Italy: a retrospective, multicentre study. Eur Respir J 2020; 56:13993003.02767-2020. [PMID: 32859682 PMCID: PMC7453732 DOI: 10.1183/13993003.02767-2020] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/06/2020] [Indexed: 12/14/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the related disease (coronavirus disease 2019; COVID-19) has been notified throughout Italy since February 2020. Intensive care unit (ICU) admission rate increased following the high incidence of pneumonia-related respiratory failure [1]. Utility and safety of bronchoscopy during the SARS-CoV-2 outbreakhttps://bit.ly/3ish52k
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Affiliation(s)
- Michele Mondoni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giuseppe Francesco Sferrazza Papa
- Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | - Rocco Rinaldo
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Paola Faverio
- School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Almerico Marruchella
- School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Francesca D'Arcangelo
- School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Alberto Pesci
- School of Medicine and Surgery, University of Milano Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | | | | | | | | | - Lisa Giuliani
- Respiratory Unit, Papa Giovanni XXIII Hospital, Dept of Health Sciences, Università degli Studi di Milano, Bergamo, Italy
| | - Fabiano Di Marco
- Respiratory Unit, Papa Giovanni XXIII Hospital, Dept of Health Sciences, Università degli Studi di Milano, Bergamo, Italy
| | - Laura Saracino
- Respiratory Diseases Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefano Tomaselli
- Respiratory Diseases Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Angelo Corsico
- Respiratory Diseases Unit, Fondazione IRCCS Policlinico San Matteo, Dept of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Stefano Gasparini
- Pulmonary Disease Unit, Dept of Internal Medicine, Azienda Ospedali Riuniti, Dept of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Martina Bonifazi
- Pulmonary Disease Unit, Dept of Internal Medicine, Azienda Ospedali Riuniti, Dept of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Lina Zuccatosta
- Pulmonary Disease Unit, Dept of Internal Medicine, Azienda Ospedali Riuniti, Dept of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Dept of Medical, Surgical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Giulia Pellegrino
- Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | - Matteo Davì
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Paolo Carlucci
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Stefano Centanni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Dept of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Medical, Surgical and Experimental Medicine, University of Sassari, Sassari, Italy
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15
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Le HY, Le VN, Pham NH, Phung AT, Nguyen TT, Do Q. Value of multidetector computed tomography angiography before bronchial artery embolization in hemoptysis management and early recurrence prediction: a prospective study. BMC Pulm Med 2020; 20:231. [PMID: 32867748 PMCID: PMC7457514 DOI: 10.1186/s12890-020-01271-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/19/2020] [Indexed: 12/19/2022] Open
Abstract
Background Multidetector computed tomography (MDCT) angiography is a useful examination to detect the source of the bleeding in patients with hemoptysis. The aim of the study was to prospectively evaluate the role and clinical efficacy of MDCT angiography before bronchial artery embolization (BAE) for the management of hemoptysis, and to investigate the predictors of early recurrence. Methods It is a double-center study which included 57 hemoptysis patients undergoing MDCT angiography prior to BAE from August 2019 to July 2020. A prospective analysis of culprit arteries detected by MDCT angiography allowed an evaluation of the role of this technique. A follow-up was done to assess the efficacy of BAE with preprocedural MDCT angiography and to explore the risk factors of early recurrent hemoptysis. Results The accuracy of MDCT angiography in the identification of culprit arteries was as high as 97.5%. The average number of total culprit arteries per patient was 2.75 ± 1.73. Among which, the average numbers of culprit ectopic bronchial arteries (BAs) and non-bronchial systemic arteries (NBSAs) per patient were 0.21 ± 0.41 and 1.04 ± 1.57, respectively. The immediate clinical success rate, total hemoptysis recurrence rate, and early hemoptysis recurrence rate of BAE following MDCT angiography were 94.7, 18.5, 16.7%, respectively. Aspergilloma (HR = 6.63, 95% CI: 1.31–33.60, p = 0.022) was associated with an increase in the risk of early recurrence. Conclusions MDCT angiography should be performed before BAE for the management of hemoptysis. Aspergilloma was an independent predictor for early recurrence.
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Affiliation(s)
- Huu Y Le
- Department of Respiratory Diseases, Military Hospital 103, Hanoi, Vietnam.,Division of Interventional Radiology, Military Hospital 103, Hanoi, Vietnam
| | - Van Nam Le
- Department of Infectious Diseases, Military Hospital 103, Hanoi, Vietnam
| | - Ngoc Hung Pham
- Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Anh Tuan Phung
- Division of Interventional Radiology, Military Hospital 103, Hanoi, Vietnam.,Department of Diagnostic Radiology, Military Hospital 103, Hanoi, Vietnam
| | - Thanh Tung Nguyen
- Department of Respiratory Diseases, Military Hospital 103, Hanoi, Vietnam.,Division of Interventional Radiology, Military Hospital 103, Hanoi, Vietnam
| | - Quyet Do
- Department of Respiratory Diseases, Military Hospital 103, Hanoi, Vietnam. .,Department of Medicine, Vietnam Military Medical University, Hanoi, Vietnam.
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16
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He B, Zhang P, Cai Q, Shi S, Xie H, Zhang Y, Peng X, Zhao Z, Yin W, Wang X. The top 100 most cited articles on bronchoscopy: a bibliometric analysis. BMC Pulm Med 2020; 20:229. [PMID: 32854666 PMCID: PMC7450920 DOI: 10.1186/s12890-020-01266-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 08/17/2020] [Indexed: 12/20/2022] Open
Abstract
Background Bronchoscopy is applied broadly in the diagnosis and treatment of pulmonary diseases. Over the past few decades, an increasing number of studies about bronchoscopy have been published. However, little is known about their qualities and characteristics. Methods All of the databases in Web of Science (including the Web of Science Core Collection, BIOSIS Citation Index, KCI-Korean Journal Database, MEDLINE, Russian Science Citation Index, and SciELO Citation Index) were utilized to identify articles published from 1990 to 2020. The top 100 most cited articles about bronchoscopy were selected for degree centrality analysis and analyses regarding publication time, total citation number, the citation density, time-related flux, first author, published journal, geographic origin, and research theme. Results The selected articles were published mainly in the 2000s and 1990s. Citations per article ranged from 731 to 196. The leading country was the USA, followed by the United Kingdom. The most frequently studied themes were bronchoalveolar lavage (BAL) fluid and biopsy. The degree centrality analysis connoted that “BAL, inflammation, diagnosis” had a high degree of centrality in the 1990s, while “diagnosis, BAL, biopsy, prospective” took centre stage in the 2000s. Conclusions The time, area, and theme distribution of the 100 most cited articles on bronchoscopy have been thoroughly analyzed. It is noticeable that researches based on BAL and endobronchial or transbronchial biopsies currently plays a major role.
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Affiliation(s)
- Boxue He
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.,Hunan Key Laboratory of Early Diagnosis and Precision Therapy, Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Pengfei Zhang
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.,Hunan Key Laboratory of Early Diagnosis and Precision Therapy, Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Qidong Cai
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.,Hunan Key Laboratory of Early Diagnosis and Precision Therapy, Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Shuai Shi
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.,Hunan Key Laboratory of Early Diagnosis and Precision Therapy, Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Hui Xie
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.,Hunan Key Laboratory of Early Diagnosis and Precision Therapy, Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Yuqian Zhang
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.,Hunan Key Laboratory of Early Diagnosis and Precision Therapy, Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xiong Peng
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.,Hunan Key Laboratory of Early Diagnosis and Precision Therapy, Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Zhenyu Zhao
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.,Hunan Key Laboratory of Early Diagnosis and Precision Therapy, Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Wei Yin
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.,Hunan Key Laboratory of Early Diagnosis and Precision Therapy, Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Xiang Wang
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China. .,Hunan Key Laboratory of Early Diagnosis and Precision Therapy, Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
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17
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Mondoni M, Sotgiu G. The Role of Early Bronchoscopy in Stable Patients With Mild Hemoptysis: New Insights for Clinical Decision-Making. Chest 2020; 158:430-431. [PMID: 32654724 DOI: 10.1016/j.chest.2020.01.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/08/2020] [Accepted: 01/10/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Michele Mondoni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences (Dr Mondoni), Università degli Studi di Milano, Milan, Italy.
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Clinical and Experimental Medicine (Dr Sotgiu), University of Sassari, Sassari, Italy
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18
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Davidson K, Shojaee S. Response. Chest 2020; 158:431-432. [PMID: 32654725 DOI: 10.1016/j.chest.2020.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/06/2020] [Indexed: 10/23/2022] Open
Affiliation(s)
- Kevin Davidson
- WakeMed Health, Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Raleigh, NC
| | - Samira Shojaee
- Virginia Commonwealth University Health System, Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Richmond, VA.
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19
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Mondoni M, Rinaldo RF, Carlucci P, Terraneo S, Saderi L, Centanni S, Sotgiu G. Bronchoscopic sampling techniques in the era of technological bronchoscopy. Pulmonology 2020; 28:461-471. [PMID: 32624385 DOI: 10.1016/j.pulmoe.2020.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 02/07/2023] Open
Abstract
Flexible bronchoscopy is a key diagnostic and therapeutic tool. New endoscopes and technologically advanced navigational modalities have been recently introduced on the market and in clinical practice, mainly for the diagnosis of mediastinal lymph adenopathies and peripheral lung nodules. Bronchoscopic sampling tools have not changed significantly in the last three decades, with the sole exception of cryobiopsy. We carried out a non-systematic, narrative literature review aimed at summarizing the scientific evidence on the main indications/contraindications, diagnostic yield, and safety of the available bronchoscopic sampling techniques. Performance of bronchoalveolar lavage, bronchial washing, brushing, forceps biopsy, cryobiopsy and needle aspiration techniques are described, focusing on indications and diagnostic accuracy in the work-up of endobronchial lesions, peripheral pulmonary abnormalities, interstitial lung diseases, and/or hilar-mediastinal lymph adenopathies. Main factors affecting the diagnostic yield and the navigational methods are evaluated. Preliminary data on the utility of the newest sampling techniques (i.e., new needles, triple cytology needle brush, core biopsy system, and cautery-assisted transbronchial forceps biopsy) are shown. TAKE HOME MESSAGE: A deep knowledge of bronchoscopic sampling techniques is crucial in the era of technological bronchoscopy for an optimal management of respiratory diseases.
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Affiliation(s)
- M Mondoni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - R F Rinaldo
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - P Carlucci
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - S Terraneo
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - L Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical, Experimental Sciences, University of Sassari, Sassari, Italy
| | - S Centanni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - G Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical, Experimental Sciences, University of Sassari, Sassari, Italy.
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20
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Mondoni M, Centanni S, Sotgiu G. New perspectives on difficult-to-treat tuberculosis based on old therapeutic approaches. Int J Infect Dis 2020; 92S:S91-S99. [PMID: 32114204 DOI: 10.1016/j.ijid.2020.02.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 12/11/2022] Open
Abstract
Tuberculosis (TB) is an important clinical and public health issue worldwide. Despite improved treatment success rates following the introduction of antibiotics in daily clinical practice, the expected decline in incidence has been hampered by HIV epidemics and multi- and extensively drug-resistant TB. During the pre-antibiotic era, TB therapies were mainly based on improving hygiene conditions, strengthening the immune system, and targeting the rest of the affected lungs with invasive techniques. Detailed knowledge of old non-pharmacological therapies might support physicians and researchers in the identification of new solutions for difficult-to-treat patients. We performed a narrative literature review on the main old therapeutic options prescribed for patients with TB. The main recommendations and contraindications of sanatorium therapies (i.e., bed rest, fresh air, sunlight) and pulmonary collapse techniques are reviewed, evaluating their physiological basis and their impact on patient outcomes. We report studies describing new interventional pulmonary and surgical techniques and assess new perspectives based on old medical and surgical treatments, whose potential implementation could help complicated patients.
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Affiliation(s)
- Michele Mondoni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Stefano Centanni
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
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Wang BR, Bongers KS, Cardenas-Garcia J. Hemoptysis: Rethinking Management. CURRENT PULMONOLOGY REPORTS 2019. [DOI: 10.1007/s13665-019-00234-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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