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Cardiac dysrhythmias in the course of flexible fiberoptic bronchoscopy
140
Tubercle and Lung Disease: Supplement
511 PLEURAL NEEDLE BIOPSY Zsiray, M., Lantos, A., Szondy, K.
9.358 + 1.843 kPa. There was no significant decrease of oxygen pressure in the first group during and after FFB. Chi’ test was used for statistical calculation.
A total of 171 pleural needle biopsies were carried out in 123 patients with pleura1 effusion. The sensitivity of the method proved to be 51% for malignant diseases and 75 % for tuberculotic pleurisy, respectively. Performing biopsy simultaneously with the cytological examination of the pleura1 fluid, malignancy was proved only by needle biopsy in 20% of the patients, while cytology was found negative in these cases. Simultaneously performed thoracocentesis and pleural needle biopsy is suggested.
The mean value of oxygen pressure before FFB in the second group was 10.709 t 1.695 kPa, during FFB it was 10.709 + 2.153 kPa, and after FFB this mean value was 9.888 t- 1.659 kPA. In the second group there was a statistically significant decrease of oxygen pressure after FFB in relation to the values during the procedure, and a highly significant decrease of oxygen pressure in relation to the initial values (p < 0.005).
512 ENZYMIC METHOD FOR DIFFERENTIA-
According to these results we suggest the introduction of oxygen during and one hour after FFB in patients who develop cianosis during the procedure, in spite of satisfactory oxygen pressure before FFB.
TION DIAGNOSIS IN LYMPHOCYTARY PLEURAL EFFUSIONS Pdunescu,E., Mihallan, F., Dumitrescu, M., Smarandache, M., Inst. Pneumophtisiology, Romania
SOS. Viilor 90, RO-75219
Bucarest,
Three enzyme activities (ADA-adenosin-deaminase,. LDH-lactat dehydrogenase, LYZ-lysozime) were simultaneously evaluated both in pleural fluid (pf) and blood serum (bs) of 202 patients with lymphocytary pleurisis, among which: 79 tuberculosis (TBC), 76 neoplastic (NEO), and 47 parapneumonic (PARA) pleurisis. The obtained results allowed an establishment of pf/bs rates between mean concentrations of each enzyme activity in pf and bs, respectively. The diagnosis capacity of an enzyme activity determined only in the pleura1 effusions. The obtained pf/bs rates were different in case of the 3 groups of pleurisis, namely: - ADA: 2.06 (TBC), 1.03 (NEO), 1.19 (PARA) - LDH: 2.12 (TBC), 0.74 (NEO), 1.68 (PARA) - LYZ: 1.85 (TBC), 0.86 (NEO), 1.27 (PARA) These pf/bs rates allow a differentiation with diagnosis value between TBC and NE0 pleural effusions, particularly when the pf/bs rates were taked into consideration in association: ADA+LDH or ADA+LYZ (specificity - 95; 97 % ; sensitivity - 90; 88 %). A similar diagnostic differentiation between TBC and PARA pleural effusions is not possible by using such enzyme activities determined either in pf or in bs, or simultaneously in both these biological fluids. 513 EFFECTS OF FIBEROPTIC BRONCHOS-
COPY ON RASPIRATORY ARTERIAL BLOOD
GASSES IN
Vasic, N., Vukcevic, M., Sudjic, E., Tucakovic, M.; University Clinical Center, Institute for Lung Diseases and Tuberculosis, Belgrade, Yugoslavia
In our prospective study we analyzed 80 patients who underwent flexible fiberoptic bronchoscopy (FFB) and their respiratory gasses in arterial blood 30 minutes prior to, during, and 30 minutes after FFB. The patients were divided into two groups. The first group consisted of 21 patients (26.30 %) who received 02 during and after FFB. The second group consistend of 59 patients (73.80 %) who did not receive Oz. All patients had satisfactory oxygen pressure before FFB. Development of cianosis was the indication for introducing O2 during the procedure. There were no significant changes in carbondioxide pressure and pH in the whole group. The mean value of oxygen pressure before FFB in the first group was 10.125 f 1.642 kPa, during FFB this value was 10.896 + 3.303 kPa, and after FFB it was
514 CARDIAC DYSRHYTHMIAS
IN THE COURSE OF FLEXIBLE FIBEROPTIC BRONCHOSCOPY
Vasic, N., Tukakovic, M., Sudjic, E., Radosavljevic, G., Gajic, M.; Institute of Pulmonary Diseases and TB UKC, 11000 Belgrade, Visegradska 26, Yugoslavia
Continuous electrocardiographic monitoring was performed in 80 pts during flexible fiberoptic bronchoscopy (FFB) aiming at investigating arrhytmogenic potential of the procedure itself. The pts were randomly selected. Arrhythmia was preceding FFB in 12 (15%) and accompanying FFB in 55 (69 %) pts, the difference being highly significant (p < 0.01). Arrhythmias occurring during FFB were described as MAJOR (SB with frequency below 401 min, PSVT with fr. above 160/min, atria1 fibrillation with fr. above 16O/min and VES of II act. to Lown) and MINOR (ST, SVES adn VES I act. to Lown). Major arrhyhtmias were recorded in 22 (27.5 %), minor in 33 (41.3 %), while 25 pts (31.3 %) had none. Thirty minutes after FFB ECG recorded major arrhythmias in 1 (1 %), minor in 28 (35 %) and none in 51 (64%) pts. The study suggested that dysrhythmias accompanying FFB were induced by the procedure itself and, most probably transitory hypoxemia. Antiarrhythmic effect is achieved by addition of oxygen during the procedure. 515 CORONARY
INSUFFICIENCY AmER FLEXIBLE FIBEROPTIC BRONCHOSCOPY
Vasic, N., Vukcevic,M., Sudjic, E., Tucakovic, M.; Institute of Pulmonary Diseases and TB UKC, 11000 Belgrade, Visegradska 26, Yugoslavia
Continuous electrocardiographic monitoring was conducted in the course of flexible fiberoptic bronchoscopy (FFB) in 80 pts aiming at investigations of ECG changes in pts with coronary insufficiency (scar after infarction, ST-T changes). Before the study, ECG verification of “coronary insufficiency” was obtained in 6 (7.5 %), while 74 (92.5 R) were free of it. This group also included 5 pts with positive history, without ECG verification of “coronary insufficiency”. Half an hour after FFB standard 12 channel ECG was performed. In the course of FFB 7 (9%) pts had ECG sings of coronary insufficiency, while 73 (91%) pts were free of these ECG sings.
Tubercle and Lung Disease: Supplement
511 PLEURAL NEEDLE BIOPSY Zsiray, M., Lantos, A., Szondy, K.
9.358 + 1.843 kPa. There was no significant decrease of oxygen pressure in the first group during and after FFB. Chi’ test was used for statistical calculation.
A total of 171 pleural needle biopsies were carried out in 123 patients with pleura1 effusion. The sensitivity of the method proved to be 51% for malignant diseases and 75 % for tuberculotic pleurisy, respectively. Performing biopsy simultaneously with the cytological examination of the pleura1 fluid, malignancy was proved only by needle biopsy in 20% of the patients, while cytology was found negative in these cases. Simultaneously performed thoracocentesis and pleural needle biopsy is suggested.
The mean value of oxygen pressure before FFB in the second group was 10.709 t 1.695 kPa, during FFB it was 10.709 + 2.153 kPa, and after FFB this mean value was 9.888 t- 1.659 kPA. In the second group there was a statistically significant decrease of oxygen pressure after FFB in relation to the values during the procedure, and a highly significant decrease of oxygen pressure in relation to the initial values (p < 0.005).
512 ENZYMIC METHOD FOR DIFFERENTIA-
According to these results we suggest the introduction of oxygen during and one hour after FFB in patients who develop cianosis during the procedure, in spite of satisfactory oxygen pressure before FFB.
TION DIAGNOSIS IN LYMPHOCYTARY PLEURAL EFFUSIONS Pdunescu,E., Mihallan, F., Dumitrescu, M., Smarandache, M., Inst. Pneumophtisiology, Romania
SOS. Viilor 90, RO-75219
Bucarest,
Three enzyme activities (ADA-adenosin-deaminase,. LDH-lactat dehydrogenase, LYZ-lysozime) were simultaneously evaluated both in pleural fluid (pf) and blood serum (bs) of 202 patients with lymphocytary pleurisis, among which: 79 tuberculosis (TBC), 76 neoplastic (NEO), and 47 parapneumonic (PARA) pleurisis. The obtained results allowed an establishment of pf/bs rates between mean concentrations of each enzyme activity in pf and bs, respectively. The diagnosis capacity of an enzyme activity determined only in the pleura1 effusions. The obtained pf/bs rates were different in case of the 3 groups of pleurisis, namely: - ADA: 2.06 (TBC), 1.03 (NEO), 1.19 (PARA) - LDH: 2.12 (TBC), 0.74 (NEO), 1.68 (PARA) - LYZ: 1.85 (TBC), 0.86 (NEO), 1.27 (PARA) These pf/bs rates allow a differentiation with diagnosis value between TBC and NE0 pleural effusions, particularly when the pf/bs rates were taked into consideration in association: ADA+LDH or ADA+LYZ (specificity - 95; 97 % ; sensitivity - 90; 88 %). A similar diagnostic differentiation between TBC and PARA pleural effusions is not possible by using such enzyme activities determined either in pf or in bs, or simultaneously in both these biological fluids. 513 EFFECTS OF FIBEROPTIC BRONCHOS-
COPY ON RASPIRATORY ARTERIAL BLOOD
GASSES IN
Vasic, N., Vukcevic, M., Sudjic, E., Tucakovic, M.; University Clinical Center, Institute for Lung Diseases and Tuberculosis, Belgrade, Yugoslavia
In our prospective study we analyzed 80 patients who underwent flexible fiberoptic bronchoscopy (FFB) and their respiratory gasses in arterial blood 30 minutes prior to, during, and 30 minutes after FFB. The patients were divided into two groups. The first group consisted of 21 patients (26.30 %) who received 02 during and after FFB. The second group consistend of 59 patients (73.80 %) who did not receive Oz. All patients had satisfactory oxygen pressure before FFB. Development of cianosis was the indication for introducing O2 during the procedure. There were no significant changes in carbondioxide pressure and pH in the whole group. The mean value of oxygen pressure before FFB in the first group was 10.125 f 1.642 kPa, during FFB this value was 10.896 + 3.303 kPa, and after FFB it was
514 CARDIAC DYSRHYTHMIAS
IN THE COURSE OF FLEXIBLE FIBEROPTIC BRONCHOSCOPY
Vasic, N., Tukakovic, M., Sudjic, E., Radosavljevic, G., Gajic, M.; Institute of Pulmonary Diseases and TB UKC, 11000 Belgrade, Visegradska 26, Yugoslavia
Continuous electrocardiographic monitoring was performed in 80 pts during flexible fiberoptic bronchoscopy (FFB) aiming at investigating arrhytmogenic potential of the procedure itself. The pts were randomly selected. Arrhythmia was preceding FFB in 12 (15%) and accompanying FFB in 55 (69 %) pts, the difference being highly significant (p < 0.01). Arrhythmias occurring during FFB were described as MAJOR (SB with frequency below 401 min, PSVT with fr. above 160/min, atria1 fibrillation with fr. above 16O/min and VES of II act. to Lown) and MINOR (ST, SVES adn VES I act. to Lown). Major arrhyhtmias were recorded in 22 (27.5 %), minor in 33 (41.3 %), while 25 pts (31.3 %) had none. Thirty minutes after FFB ECG recorded major arrhythmias in 1 (1 %), minor in 28 (35 %) and none in 51 (64%) pts. The study suggested that dysrhythmias accompanying FFB were induced by the procedure itself and, most probably transitory hypoxemia. Antiarrhythmic effect is achieved by addition of oxygen during the procedure. 515 CORONARY
INSUFFICIENCY AmER FLEXIBLE FIBEROPTIC BRONCHOSCOPY
Vasic, N., Vukcevic,M., Sudjic, E., Tucakovic, M.; Institute of Pulmonary Diseases and TB UKC, 11000 Belgrade, Visegradska 26, Yugoslavia
Continuous electrocardiographic monitoring was conducted in the course of flexible fiberoptic bronchoscopy (FFB) in 80 pts aiming at investigations of ECG changes in pts with coronary insufficiency (scar after infarction, ST-T changes). Before the study, ECG verification of “coronary insufficiency” was obtained in 6 (7.5 %), while 74 (92.5 R) were free of it. This group also included 5 pts with positive history, without ECG verification of “coronary insufficiency”. Half an hour after FFB standard 12 channel ECG was performed. In the course of FFB 7 (9%) pts had ECG sings of coronary insufficiency, while 73 (91%) pts were free of these ECG sings.