David Stahl

All Publications

• Current Trends in Mortality Attributable to Racial or Ethnic Disparities in Post-Surgical Population in The United States: A Population-Based Study. Annals of surgery open : perspectives of surgical history, education, and clinical approaches Mpody, C., Best, A. F., Lee, C. N., Stahl, D. L., Raman, V. T., Urman, R. D., Tobias, J. D., Nafiu, O. O. 2023; 4 (4): e342

  Abstract

  Background: No study has contextualized the excess mortality attributable to racial and ethnic disparities in surgical outcomes. Further, not much effort has been made to quantify the effort needed to eliminate these disparities.Objective: We examined the current trends in mortality attributable to racial or ethnic disparities in the US postsurgical population. We then identified the target for mortality reduction that would be necessary to eliminate these disparities by 2030.Methods: We performed a population-based study of 1,512,974 high-risk surgical procedures among adults (18-64 years) performed across US hospitals between 2000 and 2020.Results: Between 2000 and 2020, the risk-adjusted mortality rates declined for all groups. Nonetheless, Black patients were more likely to die following surgery (adjusted relative risk 1.42; 95% CI, 1.39-1.46) driven by higher Black mortality in the northeast (1.60; 95% CI, 1.52-1.68), as well as the West (1.53; 95% CI, 1.43-1.62). Similarly, mortality risk remained consistently higher for Hispanics compared with White patients (1.21; 95% CI, 1.19-1.24), driven by higher mortality in the West (1.26; 95% CI, 1.21-1.31). Overall, 8364 fewer deaths are required for Black patients to experience mortality on the same scale as White patients. Similar figures for Hispanic patients are 4388. To eliminate the disparity between Black and White patients by 2030, we need a 2.7% annualized reduction in the projected mortality among Black patients. For Hispanics, the annualized reduction needed is 0.8%.Conclusions: Our data provides a framework for incorporating population and health systems measures for eliminating disparity in surgical mortality within the next decade.

  View details for DOI 10.1097/AS9.0000000000000342

  View details for PubMedID 38144482

• Pulmonary artery pulsatility index as a predictor of right ventricular failure in left ventricular assist device recipients: A systematic review JOURNAL OF HEART AND LUNG TRANSPLANTATION Essandoh, M., Kumar, N., Hussain, N., Dalia, A. A., Wang, D., Al-Qudsi, O., Wilsak, D., Stahl, D., Bhatt, A., Awad, H., Sawyer, T. R., Iyer, M. H. 2022; 41 (8): 1114-1123

  Abstract

  It is critical to identify patients at increased risk of right ventricular failure (RVF) before left ventricular assist device (LVAD) implantation. Pulmonary artery pulsatility index (PAPi) is a hemodynamic parameter that is a specific measure of right ventricular function and may better identify LVAD recipients at risk for RVF. This systematic review analyzes the predictive value of preoperative PAPi to RVF in the setting of LVAD implantation.Databases were searched for all studies reporting on PAPi and RVF after LVAD implantation. Data collected included: number of patients, patient characteristics, incidences of RVF, PAPi, central venous pressure (CVP), CVP/pulmonary capillary wedge pressure, tricuspid annular plane systolic excursion, and right ventricular stroke work index.Thirty-two studies (4,756 patients) were included in this review. The incidence of RVF was found to be 27.48% (1,307 patients). The weighted mean (standard deviation) of preoperative PAPi associated with RVF vs No RVF was 2.17 (2.36) and 2.87 (3.21), respectively. When comparing LVAD recipients with RVF and No RVF, patients who developed RVF had a significantly lower preoperative PAPi by a WMD (95% CI) of -0.74 [-1.00, -0.49] (p < .001). The remaining variables (CVP; CVP/pulmonary capillary wedge pressure; tricuspid annular plane systolic excursion; and right ventricular stroke work index) were also confirmed as predictors of RVF after LVAD implantation.This systematic review demonstrates the utility of PAPi as a clinical predictor of RVF after LVAD implantation. Based on our findings, we recommend that PAPi be used in conjunction with traditional hemodynamic parameters when risk stratifying LVAD recipients for RVF.

  View details for DOI 10.1016/j.healun.2022.04.007

  View details for Web of Science ID 000836236800014

  View details for PubMedID 35644726

• Oxygen saturation in pregnant individuals with COVID-19: time for re-appraisal? AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY Eid, J., Stahl, D., Costantine, M. M., Rood, K. M. 2022; 226 (6): 813-816

  Abstract

  Managing pregnant individuals with acute respiratory disease secondary to COVID-19 has been a challenge. Most professional societies including the Society for Maternal-Fetal Medicine recommend keeping O2 saturation at ≥95% in pregnant individuals. Reaching this target has been increasingly difficult in some patients, especially during the latest wave of infections attributed to the delta variant of SARS-CoV-2. In the absence of adequate supporting data, and in the setting of a reassuring fetal status, we propose that maternal O2 saturation should be maintained between 92% and 96% for admitted patients with acute respiratory failure who require supplemental O2. This may prevent unnecessary invasive interventions that might not hold maternal or fetal benefit, specifically at very preterm gestational ages.

  View details for DOI 10.1016/j.ajog.2021.12.023

  View details for Web of Science ID 000836820300008

  View details for PubMedID 34922921

  View details for PubMedCentralID PMC8675122

• COVID-Activated Emergency Scaling of Anesthesiology Responsibilities Intensive Care Unit ANESTHESIA AND ANALGESIA Verdiner, R. E., Choukalas, C. G., Siddiqui, S., Stahl, D. L., Galvagno, S. M., Jabaley, C. S., Bartz, R. R., Lane-Fall, M., Goff, K. L., Sreedharan, R., Bennett, S., Williams, G. W., Khanna, A. K. 2020; 131 (2): 365-377

  Abstract

  In response to the rapidly evolving coronavirus disease 2019 (COVID-19) pandemic and the potential need for physicians to provide critical care services, the American Society of Anesthesiologists (ASA) has collaborated with the Society of Critical Care Anesthesiologists (SOCCA), the Society of Critical Care Medicine (SCCM), and the Anesthesia Patient Safety Foundation (APSF) to develop the COVID-Activated Emergency Scaling of Anesthesiology Responsibilities (CAESAR) Intensive Care Unit (ICU) workgroup. CAESAR-ICU is designed and written for the practicing general anesthesiologist and should serve as a primer to enable an anesthesiologist to provide limited bedside critical care services.

  View details for DOI 10.1213/ANE.0000000000004957

  View details for Web of Science ID 000551907100024

  View details for PubMedID 32398432

  View details for PubMedCentralID PMC7219847

• Blood Product Replacement for Postpartum Hemorrhage CLINICAL OBSTETRICS AND GYNECOLOGY Eid, J., Stahl, D. 2023; 66 (2): 408-414

  Abstract

  Consideration for blood products replacement in postpartum hemorrhage should be given when blood loss exceeds 1.5 L or when an estimated 25% of blood has been lost. In cases of massive hemorrhage, standardized transfusion protocols have been shown to improve maternal morbidity and mortality. Most protocols recommend a balanced transfusion involving a 1:1:1 ratio of packed red blood cells, platelets, and fresh frozen plasma. Alternatives such as cryoprecipitate, fibrinogen concentrate, and prothrombin complex concentrates can be used in select clinical situations. Although transfusion of blood products can be lifesaving, it does have associated risks.

  View details for DOI 10.1097/GRF.0000000000000766

  View details for Web of Science ID 000994927500017

  View details for PubMedID 36730283

• Challenges in maintaining oxygen saturation in pregnant individuals residing in low- and middle-income countries: a response AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY Eid, J., Stahl, D., Rood, K. M. 2023; 228 (3): 357

  View details for DOI 10.1016/j.ajog.2022.10.018

  View details for Web of Science ID 000943278900001

  View details for PubMedID 36309309

  View details for PubMedCentralID PMC9605780

• A Multi-Site Survey Study on the Association Between the COVID-19 Pandemic and United States Anesthesiology Residents' Mental Health CUREUS JOURNAL OF MEDICAL SCIENCE Chen, F., Isaak, R., Afroze, F., Mulaikal, T. A., Licatino, L. K., Ladlie, B., Jain, A., Willie, C., Bairde, E., Hayes, B. H., Carter, T., Zisblatt, L., Diachun, C., Martin, T. W., Marshall, J. M., Huffmyer, J., Hindle, A. K., Stahl, D. L., Liu, Y., Martinelli, S. M. 2023; 15 (2): e34782

  Abstract

   At the onset of the coronavirus disease 2019 (COVID-19) pandemic, anesthesiology residency programs were impacted differently due to various factors such as the local severity of COVID-19, exposure to patient suffering, and inability to complete rotations. We sought to investigate the impact of local-level pandemic severity on the well-being of anesthesiology residents. This multi-site study surveyed postgraduate year two residents from 15 United States (US) anesthesiology programs using the Perceived Stress Scale, Mini-Z, Patient Health Questionnaire-9,WHO-5 Well-Being Index,and the Multidimensional Scale of Perceived Social Support before the pandemic (baseline survey) and during the first COVID-19 surge (post survey). A total of 144 (65%) residents responded to the initial baseline survey; 73 (33%) responded to the post survey, and 49 (22%) completed both surveys. There was not a statistically significant difference in any well-being outcomes of participants between the surveys, nor was there a significant difference based on the severity of COVID-19 impact at the program's hospital. Male participants had higher perceived stress scores (β = 4.05, 95%CI: 0.42, 7.67, P = 0.03) and lower social support from family (β = -6.57, 95%CI: -11.64, -1.51, P = 0.01) at the post survey compared to female participants after controlling for baseline scores. Additionally, married participants or those with domestic partners reported higher perceived social support in the post survey (β = 5.79, 95%CI: -0.65, 12.23, P = 0.03). The local COVID-19 severity at a residency program did not disproportionately impact well-being scores among anesthesiology residents. Those most vulnerable to diminished well-being appeared to be male and single participants. As a result, targeted well-being interventions, including those aiming to increase social support, to higher-risk resident groups may be indicated. Future work is needed to assess the longstanding COVID-19 pandemic impacts on resident well-being.

  View details for DOI 10.7759/cureus.34782

  View details for Web of Science ID 000952797700011

  View details for PubMedID 36915835

  View details for PubMedCentralID PMC10005895

• Association of Severe Obesity and Chronic Obstructive Pulmonary Disease With Pneumonia Following Non-Cardiac Surgery JOURNAL OF CLINICAL MEDICINE RESEARCH-CANADA Owusu-Bediako, K., Pfaff, K., Tram, N. K., Stahl, D. L., Tobias, J. D., Nafiu, O. O., Mpody, C. 2022; 14 (6): 237-243

  Abstract

  Pneumonia is the third most common surgical complication after urinary tract infection and wound infections. In addition to increased mortality, patients who develop postoperative pneumonia have a higher risk of prolonged hospital stay, intensive care unit (ICU) admissions, and higher healthcare costs. Obesity and chronic obstructive pulmonary disease (COPD) are both independent risk factors for the development and severity of postoperative pneumonia, although the combined effect of these comorbidities is unknown. Therefore, we evaluated whether the combination of severe obesity and COPD is associated with an increased risk of postoperative pneumonia.We performed a multicenter retrospective cohort study of 365,273 patients aged 18 - 64 years who were either severely obese (body mass index (BMI) ≥ 40 kg/m2) or normal-weight (BMI between 18.6 and 24.9 kg/m2) and underwent general surgery, orthopedic surgery, neurosurgery, otolaryngology surgery, urology surgery, and vascular surgery in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) participating hospitals from 2014 to 2018. We evaluated the combined effect of COPD and severe obesity on the risk for postoperative pneumonia, unplanned tracheal reintubation, and extended length of stay.The co-occurrence of severe obesity and COPD appeared to have a protective effect on the risk of postoperative pneumonia. In the presence of COPD, patients with severe obesity were 14% less likely to develop pneumonia compared to their normal-weight counterparts (2.9% vs. 4.4%; adjusted relative risk (RR): 0.76; 95% confidence interval (CI): 0.60, 0.95). In addition, in the presence of COPD, severe obesity conferred a lower risk for requiring an extended length of stay (37.6% vs. 47.9%; adjusted RR: 0.83; 95% CI: 0.78, 0.89).Counterintuitively, the co-occurrence of severe obesity with COPD appeared to buffer the negative impact of COPD on postoperative pneumonia, unplanned tracheal reintubation, and prolonged hospital stay after noncardiac surgery. These findings are consistent with the obesity paradox and warrant further investigations.

  View details for DOI 10.14740/jocmr4741

  View details for Web of Science ID 001111167100005

  View details for PubMedID 35836727

  View details for PubMedCentralID PMC9275437

• Peripheral and uterine blood viscoelastic testing parameters during postpartum hemorrhage JOURNAL OF PERINATAL MEDICINE Ma'ayeh, M., Mashburn, S., Graves, S., Costantine, M. M., Stahl, D. L., Rood, K. M. 2022; 50 (1): 110-112

  View details for DOI 10.1515/jpm-2021-0294

  View details for Web of Science ID 000812328200018

  View details for PubMedID 34837489

• Caring for Parturients with Substance Use Disorders. Anesthesiology clinics Stahl, D. L., Matthews, L. J. 2021; 39 (4): 761-777

  Abstract

  Parturients with substance use disorder require expertise to manage the complexity of intoxication, withdrawal, and chronic use as well as ensure adequate analgesia throughout labor. Opioid use disorder in pregnancy has increased more than 4-fold in the past decade, with a 50-fold geographic variability that now dwarfs other substance use in this population. Understanding not only the medical but also the public health and criminal justice implications of substance use disorder is essential to providing optimal care to this at-risk population.

  View details for DOI 10.1016/j.anclin.2021.08.006

  View details for PubMedID 34776108

• Perineural Liposomal Bupivacaine Is Not Superior to Nonliposomal Bupivacaine for Peripheral Nerve Block Analgesia A Systematic Review and Meta-analysis ANESTHESIOLOGY Hussain, N., Brull, R., Sheehy, B., Essandoh, M. K., Stahl, D. L., Weaver, T. E., Abdallah, F. W. 2021; 134 (2): 147-164

  Abstract

  Liposomal bupivacaine is purported to extend analgesia of peripheral nerve blocks when administered perineurally. However, evidence of the clinical effectiveness of perineural liposomal bupivacaine is mixed. This meta-analysis seeks to evaluate the effectiveness of perineural liposomal bupivacaine in improving peripheral nerve block analgesia as compared with nonliposomal local anesthetics.The authors identified randomized trials evaluating the effectiveness of peripheral nerve block analgesic that compared liposomal bupivacaine with nonliposomal local anesthetics. The primary outcome was the difference in area under the receiver operating characteristics curve (AUC) of the pooled 24- to 72-h rest pain severity scores. Secondary outcomes included postoperative analgesic consumption, time to first analgesic request, incidence of opioid-related side effects, patient satisfaction, length of hospital stay, liposomal bupivacaine side effects, and functional recovery. AUC pain scores were interpreted in light of a minimal clinically important difference of 2.0 cm · h.Nine trials (619 patients) were analyzed. When all trials were pooled, AUC pain scores ± SD at 24 to 72 h were 7.6 ± 4.9 cm · h and 6.6 ± 4.6 cm · h for nonliposomal and liposomal bupivacaine, respectively. As such, perineural liposomal bupivacaine provided a clinically unimportant benefit by improving the AUC (95% CI) of 24- to 72-h pain scores by 1.0 cm · h (0.5 to 1.6; P = 0.003) compared with nonliposomal bupivacaine. Excluding an industry-sponsored trial rendered the difference between the groups nonsignificant (0.7 cm · h [-0.1 to 1.5]; P = 0.100). Secondary outcome analysis did not uncover any additional benefits to liposomal bupivacaine in pain severity at individual timepoints up to 72 h, analgesic consumption, time to first analgesic request, opioid-related side effects, patient satisfaction, length of hospital stay, and functional recovery. No liposomal bupivacaine side effects were reported.Perineural liposomal bupivacaine provided a statistically significant but clinically unimportant improvement in the AUC of postoperative pain scores compared with plain local anesthetic. Furthermore, this benefit was rendered nonsignificant after excluding an industry-sponsored trial, and liposomal bupivacaine was found to be not different from plain local anesthetics for postoperative pain and all other analgesic and functional outcomes. High-quality evidence does not support the use of perineural liposomal bupivacaine over nonliposomal bupivacaine for peripheral nerve blocks.

  View details for DOI 10.1097/ALN.0000000000003651

  View details for Web of Science ID 000639316000003

  View details for PubMedID 33372953

• Localized Cardiac Tamponade Diagnosed Using Venous Oxygen Saturation JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA Hunter, N. M., Stahl, D. 2019; 33 (2): 489-492

  View details for DOI 10.1053/j.jvca.2018.07.049

  View details for Web of Science ID 000456491700041

  View details for PubMedID 30269892

• What's New in Critical Illness and Injury Science? The association between initial blood alcohol concentration and polysubstance use may be indicative of a gateway drug effect. International journal of critical illness and injury science Davila, V. R., Stahl, D. L., Bhandary, S. P., Papadimos, T. J. 2018; 8 (4): 181-183

  View details for DOI 10.4103/IJCIIS.IJCIIS_80_18

  View details for PubMedID 30662862

• Delayed Development of Malignant Hyperthermia Following Cardiopulmonary Bypass SEMINARS IN CARDIOTHORACIC AND VASCULAR ANESTHESIA Sams, S., Revilla, S., Stahl, D. 2018; 22 (1): 95-99

  Abstract

  Malignant hyperthermia (MH) is a rare but potentially life-threatening disorder encountered during general anesthesia. The use of cardiopulmonary bypass during cardiac surgery can obscure many of the cardinal signs and symptoms of MH. The development of postoperative MH following cardiac surgery is rare, but anesthesiologists and intensivists must maintain a high index of suspicion in order to make a prompt diagnosis. Initiation and tailored maintenance of MH therapy must also consider the complex physiologic changes of patients in the immediate post-cardiac surgery period. In this article, we present a case of the development of postoperative MH in the cardiac intensive care unit after elective open heart surgery with cardiopulmonary bypass.

  View details for DOI 10.1177/1089253217732128

  View details for Web of Science ID 000424283300011

  View details for PubMedID 28922985

• Comparison of Phenylephrine and ephedrine in Treatment of Spinal-induced Hypotension in High-Risk Pregnancies: A narrative Review FRONTIERS IN MEDICINE Dusitkasem, S., Herndon, B. H., Somjit, M., Stahl, D. L., Bitticker, E., Coffman, J. C. 2017; 4: 2

  Abstract

  To compare maternal and fetal effects of intravenous phenylephrine and ephedrine administration during spinal anesthesia for cesarean delivery in high-risk pregnancies.An extensive literature search was conducted using the US National Library of Medicine, MEDLINE search engine, Cochrane review, and Google Scholar using search terms "ephedrine and phenylephrine," "preterm and term and spinal hypotension," "preeclampsia and healthy parturients," or "multiple and singleton gestation and vasopressor." Society of Obstetric Anesthesia and Perinatology meeting abstracts for the past 4 years were also searched for relevant studies.Both phenylephrine and ephedrine can be safely used to counteract hypotension after spinal anesthesia in patients with uteroplacental insufficiency, pregnancy-induced hypertension, and in non-elective cesarean deliveries. Vasopressor requirements before delivery in high-risk cesarean sections are reduced compared to healthy parturients. Among the articles reviewed, there were no statistically significant differences in umbilical arterial pH, umbilical venous pH, incidence of fetal acidosis, Apgar scores, or maternal hypotension when comparing maternal phenylephrine and ephedrine use.From the limited existing data, phenylephrine and ephedrine are both appropriate selections for treating or preventing hypotension induced by neuraxial blockade in high-risk pregnancies. There is no clear evidence that either medication is more effective at maintaining maternal blood pressure or has a superior safety profile in this setting. Further investigations are required to determine the efficacy, ideal dosing regimens, and overall safety of phenylephrine and ephedrine administration in high-risk obstetric patients, especially in the presence uteroplacental insufficiency.

  View details for DOI 10.3389/fmed.2017.00002

  View details for Web of Science ID 000407080500001

  View details for PubMedID 28164084

  View details for PubMedCentralID PMC5247437

• An exploratory, hypothesis-generating, meta-analytic study of damage control resuscitation in acute hemorrhagic shock: Examining the behavior of patient morbidity and mortality in the context of plasma-to-packed red blood cell ratios INTERNATIONAL JOURNAL OF ACADEMIC MEDICINE Barry, N., Mubang, R. N., Wojda, T. R., Evans, D. C., Sharpe, R. P., Hoff, W. S., Thomas, P., Cipolla, J., Stahl, D. L., Papadimos, T. J., Stawicki, S. P. 2016; 2 (2): 159-172

  View details for DOI 10.4103/2455-5568.196862

  View details for Web of Science ID 000640900300006

• Preventing Ventilator-Associated Lung Injury: A Perioperative Perspective FRONTIERS IN MEDICINE Kimura, S., Stoicea, N., Rafael, B., Britton, R., Shabsigh, M., Branstiter, A., Stahl, D. L. 2016; 3: 25

  Abstract

  Research into the prevention of ventilator-associated lung injury (VALI) in patients with acute respiratory distress syndrome (ARDS) in the intensive care unit (ICU) has resulted in the development of a number of lung protective strategies, which have become commonplace in the treatment of critically ill patients. An increasing number of studies have applied lung protective ventilation in the operating room to otherwise healthy individuals. We review the history of lung protective strategies in patients with acute respiratory failure and explore their use in patients undergoing mechanical ventilation during general anesthesia. We aim to provide context for a discussion of the benefits and drawbacks of lung protective ventilation, as well as to inform future areas of research.We completed a database search and reviewed articles investigating lung protective ventilation in both the ICU and in patients receiving general anesthesia through May 2015.Lung protective ventilation was associated with improved outcomes in patients with acute respiratory failure in the ICU. Clinical evidence is less clear regarding lung protective ventilation for patients undergoing surgery.Lung protective ventilation strategies, including low tidal volume ventilation and moderate positive end-expiratory pressure, are well established therapies to minimize lung injury in critically ill patients with and without lung disease, and may provide benefit to patients undergoing general anesthesia.

  View details for DOI 10.3389/fmed.2016.00025

  View details for Web of Science ID 000407042700002

  View details for PubMedID 27303668

  View details for PubMedCentralID PMC4885020

• Noise Levels in Surgical ICUs Are Consistently Above Recommended Standards CRITICAL CARE MEDICINE Tainter, C. R., Levine, A. R., Quraishi, S. A., Butterly, A. D., Stahl, D. L., Eikermann, M., Kaafarani, H. M., Lee, J. 2016; 44 (1): 147-152

  Abstract

  The equipment, monitor alarms, and acuity of patients in ICUs make it one of the loudest patient care areas in a hospital. Increased sound levels may contribute to worsened outcomes in these particularly vulnerable patients. Our objective was to determine whether ambient sound levels in surgical ICUs comply with recommendations established by the World Health Organization and Environmental Protection Agency, and whether implementation of an overnight "quiet time" intervention is associated with lower ambient sound levels.Prospective, observational cohort study.Two comparable 18-bed, surgical ICUs in a large, teaching hospital. Only one ICU had a formal overnight quiet time policy at the start of the study period.Sound levels were measured in 30-second blocks at preselected locations during the day and night over a period of 6 weeks using a simple, hand-held sound meter. All sound measurements in both units at all times exceeded recommended standards. Median minimum sound levels were lower at night in both units (50.8 and 50.3 vs 53.1 and 51.0 dB, p = 0.0003 and p = 0.009) and were similar between the two units (p = 0.52). The maximum overnight sound levels were statistically lower in the unit with the quiet time intervention implemented (62.5 vs 59.6 dB; p = 0.0040) and decreased overnight immediately after implementation of quiet time in the other unit (62.5 vs 56.1 dB; p < 0.0001). Maximum sound levels were lower inside patient rooms (52.2 vs 55.3 dB; p = 0.004), but minimum sound levels were similar (49.1 vs 49.2 dB; p = 0.23). Linear regression analysis showed that ICU census did not significantly influence sound levels.Ambient sound levels in the surgical ICUs were consistently above levels recommended by the World Health Organization and Environmental Protection Agency at all times. The use of a formal quiet time intervention was associated with a significant, but clinically irrelevant reduction in the median maximum sound level at night. Our results suggest that excessive ambient noise in the ICU is largely attributable to environmental factors, and behavior modifications are unlikely to have a meaningful impact. Future investigations, as well as hospital designs, should target interventions toward ubiquitous noise sources such as ventilation systems, which may not traditionally be associated with patient care.

  View details for DOI 10.1097/CCM.0000000000001378

  View details for Web of Science ID 000366605100017

  View details for PubMedID 26457750

• Complications of bronchoscopy: A concise synopsis. International journal of critical illness and injury science Stahl, D. L., Richard, K. M., Papadimos, T. J. 2015; 5 (3): 189-95

  Abstract

  Flexible and rigid bronchoscopes are used in diagnosis, therapeutics, and palliation. While their use is widespread, effective, and generally safe; there are numerous potential complications that can occur. Mechanical complications of bronchoscopy are primarily related to airway manipulations or bleeding. Systemic complications arise from the procedure itself, medication administration (primarily sedation), or patient comorbidities. Attributable mortality rates remain low at < 0.1% for fiberoptic and rigid bronchoscopy. Here we review the complications (classified as mechanical or systemic) of both rigid and flexible bronchoscopy in hope of making practitioners who are operators of these tools, and those who consult others for interventions, aware of potential problems, and pitfalls in order to enhance patient safety and comfort.

  View details for DOI 10.4103/2229-5151.164995

  View details for PubMedID 26557489