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VOLUME 20 , ISSUE 10 ( 2016 ) > List of Articles

CASE REPORT

Endoscopic ultrasound (with an echobronchoscope)-guided fine-needle aspiration for diagnosis of a mediastinal lesion in a mechanically ventilated patient: A case report and systematic review of the literature

Navneet Singh, Nalini Gupta, Kuruswamy Prasad, Inderpaul Sehgal, Sahajal Dhooria

Keywords : Bronchoscopy, echobronchoscope, endobronchial ultrasound, interventional pulmonology, lung cancer, mediastinal mass

Citation Information : Singh N, Gupta N, Prasad K, Sehgal I, Dhooria S. Endoscopic ultrasound (with an echobronchoscope)-guided fine-needle aspiration for diagnosis of a mediastinal lesion in a mechanically ventilated patient: A case report and systematic review of the literature. Indian J Crit Care Med 2016; 20 (10):608-612.

DOI: 10.4103/0972-5229.192057

License: CC BY-ND 3.0

Published Online: 00-10-2016

Copyright Statement:  Copyright © 2016; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is routinely used for accessing mediastinal lymph nodes and masses. However, in patients with respiratory failure, who are being mechanically ventilated through an endotracheal tube, EBUS-TBNA may not be feasible due to several reasons. In such patients, the esophageal route offers a useful alternative for accessing mediastinal lesions. Herein, we describe a 50-year-old man with a mediastinal mass, who was being invasively ventilated for respiratory failure. Endoscopic ultrasound (with an echobronchoscope)-guided fine-needle aspiration was performed, which revealed a diagnosis of small cell carcinoma. Appropriate cancer chemotherapy resulted in successful liberation of the patient from mechanical ventilation. We have also performed a systematic review of literature for reports of endoscopic diagnostic procedures for mediastinal/hilar lesions in critically ill patients.


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  1. Dhooria S, Agarwal R, Aggarwal AN, Bal A, Gupta N, Gupta D. Differentiating tuberculosis from sarcoidosis by sonographic characteristics of lymph nodes on endobronchial ultrasonography: A study of 165 patients. J Thorac Cardiovasc Surg 2014;148:662-7.
  2. Sharma M, Ecka RS, Somasundaram A, Shoukat A, Kirnake V. Endoscopic ultrasound in mediastinal tuberculosis. Lung India 2016;33:129-34.
  3. Dhooria S, Aggarwal AN, Singh N, Gupta D, Behera D, Gupta N, et al. Endoscopic ultrasound-guided fine-needle aspiration with an echobronchoscope in undiagnosed mediastinal lymphadenopathy: First experience from India. Lung India 2015;32:6-10.
  4. Dhooria S, Aggarwal AN, Gupta D, Behera D, Agarwal R. Utility and safety of endoscopic ultrasound with bronchoscope-guided fine-needle aspiration in mediastinal lymph node sampling: Systematic review and meta-analysis. Respir Care 2015;60:1040-50.
  5. Chichra A, Lama KW, Koenig SJ. Respiratory failure with hilar mass: Role of endobronchial ultrasound-guided transbronchial needle aspiration in the medical intensive care unit. Lung India 2015;32:178-81.
  6. Ghamande S, Rafanan A, Dweik R, Arroliga AC, Mehta AC. Role of transbronchial needle aspiration in patients receiving mechanical ventilation. Chest 2002;122:985-9.
  7. Koh MS, Ong TH, Phua GC, Anantham D. Feasibility of endobronchial ultrasound in mechanically ventilated patients. Ann Acad Med Singapore 2014;43:238-40.
  8. Berzosa M, Davies SF, Gupta K, Debol SM, Li R, Miranda D, et al. Diagnostic bedside EUS in the intensive care unit: A single-center experience. Gastrointest Endosc 2013;77:200-8.
  9. Fritscher-Ravens A, Schirrow L, Pothmann W, Knöfel WT, Swain P, Soehendra N. Critical care transesophageal endosonography and guided fine-needle aspiration for diagnosis and management of posterior mediastinitis. Crit Care Med 2003;31:126-32.
  10. Fritscher-Ravens A, Sriram PV, Pothman WP, Füllekrug B, Jäckle S, Thonke F, et al. Bedside endosonography and endosonography-guided fine-needle aspiration in critically ill patients: A way out of the deadlock? Endoscopy 2000;32:425-7.
  11. Varadarajulu S, Eloubeidi MA, Wilcox CM. The concept of bedside EUS. Gastrointest Endosc 2008;67:1180-4.
  12. Gupta K, Mallery S. Small-caliber endobronchial ultrasonic videoscope: Successful transesophageal and transgastric FNA after failed passage of a standard ultrasonic endoscope. Gastrointest Endosc 2007;66:574-7.
  13. Bhaskar N, Shweihat YR, Bartter T. The intubated patient with mediastinal disease - A role for esophageal access using the endobronchial ultrasound bronchoscope. J Intensive Care Med 2014;29:43-6.
  14. Abouzgheib W, Shweihat Y, Bartter T. Oesophageal applications of the convex curvilinear ultrasound bronchoscope; an illustrative case series. Respirology 2011;16:965-8.
  15. Mohamadnejad M, Leblanc JK, Sherman S, Al-Haddad M, McHenry L, Cote GA, et al. Bedside endoscopic ultrasound in critically Ill patients. Diagn Ther Endosc 2011;2011:529791.
  16. Soares M, Darmon M, Salluh JI, Ferreira CG, Thiéry G, Schlemmer B, et al. Prognosis of lung cancer patients with life-threatening complications. Chest 2007;131:840-6.
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