Bronchoscopy during non-invasive mechanical ventilation: a review of techniques and procedures.

Non-invasive mechanical ventilation (NIMV) is used to treat acute respiratory failure by improving gas exchange abnormalities and reducing the signs of respiratory effort, dyspnea and the activity of accessory respiratory muscles. Bronchoscopy is a key technique in the study of respiratory diseases that is necessary to perform in acute and critical patients, often times only after orotracheal intubation (OTI) due to possible complications of the technique. In this review, we evaluate the evidence of NIMV use during bronchoscopy, concluding that its use should be considered in severe patients as an alternative that is capable of preventing the complications related with OTI and mechanical ventilation, especially in patients with chronic obstructive pulmonary disease and with a tendency towards developing hypercapnia.