Bronchofiberscopy in the postoperative management of lung surgery patients.

A retrospective study of 60 bronchofiberscopic lavage procedures following lung surgery showed an increase of prebronchoscopy oxygen partial pressure from 64.2 mmHg (S.D. +/- 16.2) to 69.9 mmHg (S.D +/- 18.0) after bronchoscopy (P less than 0.01), while carbon dioxide partial pressure did not change significantly. Lobectomied patients tended more often to develop ipsilateral atelactases, invariably responding well to lavage; this group may benefit from prophylactic fiberoptic lavage. Cases are presented to demonstrate this point and to show the need for repeated lavage in some instances. Administration of a standard premedication dosage to patients sedated for other reasons occasionally led to worsened respiratory status; pre-medication should be reduced or eliminated in sedated patients. The effective application of lidocain and salbutamol intrabronchially is discussed. The bronchofiberscope is an important tool in optimal post-operative management of lung surgery patients.