Tracheal stenting by rigid bronchoscopy in right lateral decubitus position in an awake patient

Clarissa B Smith; Lucas Pitts; Maykol Postigo

doi:10.1016/j.heliyon.2023.e18678

Tracheal stenting by rigid bronchoscopy in right lateral decubitus position in an awake patient

Heliyon. 2023 Jul 27;9(8):e18678. doi: 10.1016/j.heliyon.2023.e18678. eCollection 2023 Aug.

Authors

Clarissa B Smith¹, Lucas Pitts², Maykol Postigo²

Affiliations

¹ The University of Kansas Health System, Department of Internal Medicine, Mailstop 1022 3901 Rainbow Boulevard, Kansas City, KS, 66160, United States.
² The University of Kansas Health System, Division of Pulmonary, Critical Care, and Sleep Medicine, United States.

Abstract

Rigid bronchoscopy is a common procedure for central airway obstructions (CAO). Many patients with advanced lesions causing CAO have tenuous, positionally dependent respiratory status which requires additional procedural considerations. This case report describes a 57-year-old man with high grade epithelioid angiosarcoma of the right lung and pleura who underwent placement of a tracheal stent by rigid bronchoscopy in the novel procedural conditions of right lateral decubitus, semi-sitting position with dexmedetomidine, midazolam, and propofol for moderate sedation. Dexmedetomidine, which is currently in use for flexible bronchoscopy due to its analgesic, anxiolytic, and antisialogogue properties performed ideally and should be further evaluated for this indication.

Keywords: Central airway occlusion; Dexmedetomidine; Interventional pulmonology; Rigid bronchoscopy; Tracheal stent.

Publication types

Case Reports