To the Editor.—
Bronchoscopy, an important therapeutic measure in the treatment of respiratory failure, is frequently not employed because of the risk associated with difficulty in maintaining adequate ventilation and oxygenation as well as technical difficulties encountered in attempting conventional bronchoscopy in patients with respiratory failure. The fiberoptic bronchoscope obviates most of these problems and allows repeated, safe bronchoscopy to be used as a therapeutic adjunct in the treatment of respiratory failure. This paper describes the technique of fiberoptic bronchoscopy during respiratory failure.
The instrument used is 5 mm in diameter, 55.7 cm in working length, and has a remotely controllable flexing tip and a channel, 1 mm in diameter, through which anesthetic or lavaging solutions may be instilled or secretions aspirated. The instrument is inserted through the suction part in an anesthetic elbow connected between the mechanical ventilator and endotracheal tube. A device to maintain an airtight seal