期刊
RESPIRATION
卷 100, 期 7, 页码 611-617出版社
KARGER
DOI: 10.1159/000515442
关键词
Migration; Pressure difference; Flow limitation; Maximal obstruction
资金
- Japan Society for the Promotion of Science [28]
Physiological assessment of extensive airway obstruction using point-by-point P-lat measurement can identify the location of maximal obstruction and guide the need for additional procedures in real time.
Background: The positioning of the stent at the flow-limiting segment is crucial for patients with extensive airway obstruction to relieve dyspnea. However, CT and flow-volume curves cannot detect the area of maximal obstruction. Objectives: The aim of this study is to physiologically evaluate extensive airway obstruction during interventional bronchoscopy. Methods: We prospectively measured point-by-point lateral airway pressure (P-lat) at multiple points from the lower lobe bronchus to the upper trachea using a double-lumen catheter in 5 patients. The site of maximal obstruction was evaluated continuously to measure point-by-point P-lat at multiple points when the airway catheter was withdrawn from the lower lobe bronchus to the upper trachea. Results: Remarkable pressure differences occurred at the site of maximal obstruction assessed by point-by-point P-lat measurements. After initial stenting in 1 case, migration of the maximal obstruction to a nonstented segment of the weakened airway was seen with extensive stenosis from the trachea to the bronchi. In the second case, in addition to radiological analysis, point-by-point P-lat measurements could identify the location of the maximal obstruction which contributed to dyspnea. Conclusions: Point-by-point P-lat measurement could be used to detect the site of maximal obstruction physiologically. Furthermore, P-lat measurement could assess the need for additional procedures in real time in patients with extensive airway obstruction.
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