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Life-Saving Bronchoscopy Procedure Successfully Performed on Critical Patient

Life-Saving Bronchoscopy Procedure Successfully Performed on Critical Patient

In a remarkable medical intervention, a collaborative team of doctors at Kasturba Hospital, Sevagram, successfully performed a life-saving bronchoscopy procedure. The patient was a 58-year-old gentleman with diabetes and hypertension admitted in critically ill condition to the Medicine ICU with Left Upper Lobe pneumonia and acute respiratory failure. His critical condition was expertly managed by the medical team led by Dr Sumedh Jajoo (Professor, Department of Medicine) and Dr Ajay Lanjewar (Professor, Respiratory Medicine).

Rapidly deteriorating conditions on admission necessitated intubation and mechanical ventilation. Despite appropriate antibiotics, the pneumonia did not improve. "The left lung became completely white, indicating that secretions were blocking the airway and preventing any improvement with the pneumonia," said Dr Sumedh Jajoo. Due to the patient's oxygen requirements reaching 80%, a decision was made to perform a bedside bronchoscopy, which is both a diagnostic and therapeutic procedure.

The medical team faced significant challenges while performing bronchoscopy due to the high oxygen requirement and the use of a 7.5-size endotracheal tube. The risk of damage to delicate scope and constant air leak was substantial when using a 6 mm fiber optic bronchoscope. However, after weighing the pros and cons, the team decided to proceed with the bronchoscopy procedure.

"We are immensely grateful to the ENT department for their generous support in sharing their bronchoscope, which played a vital role in this life-saving procedure,” said Dr Ajay Lanjewar. He expertly led the procedure, with assistance from Dr Pravin Satkar (Assistant Professor) and additional support from Vandana Sunar (Staff Nurse), Totaram Bakde (Brother), Dr Manali More (Junior Resident 2, Department of Medicine), and Dr Vivek Kachure (Junior Resident 1, Department of Medicine). The supporting team and staff were well-prepared for the procedure, and their collaborative effort and quick response were instrumental in achieving a favorable outcome, as stated by Dr Lanjewar.

During the bronchoscopy procedure, the scope was inserted  4 -5  times through the ET tube. The medical team monitored the patient's oxygenation and hemodynamics. The findings showed that there was a mucus build-up at the distal end of the tube, an obstruction in the left main bronchus, and dry crust at the distal end of the ET tube. The medical team then took the necessary steps to clear the mucus plug. They instilled 10-20 ml saline aliquots, aspirated secretions, and applied strong suction through the endotracheal tube with a catheter. This approach was successful in removing the obstruction. The patient's condition improved remarkably, as was evidenced by a follow-up chest X-ray taken 90 minutes after the procedure. The patient's oxygen requirement dropped from 80% to 65%.

Three days post-procedure, the patient's significantly improved and oxygen requirement was reduced. Dr Sumedh Jajoo successfully removed the ventilator support and placed him on high-flow oxygen therapy as the patient was breathing comfortably.  

"The successful outcome of this case serves as a testament to the exceptional medical care provided at Kasturba Hospital. The positive results of this life-saving bronchoscopy have further motivated the medical team to continue delivering the best possible care to all patients", said Dr Poonam Shivkumar Varma (Medical Superintendent, Kasturba Hospital).

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Last Modified: Friday 07 June 2024.

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