Equipment and procedural setup for interventional pulmonology procedures in the intensive care unit

• Published in: Journal of thoracic disease Vol. 13; no. 8; pp. 5331 - 5342
• Main Authors: Ray, Amrik S., Holden, Van K., Sachdeva, Ashutosh, Nasim, Faria
• Format: Journal Article
• Language: English
• Published: AME Publishing Company 01-08-2021
• Subjects: Review on Interventional Pulmonology in the Intensive Care Unit
• ISSN: 2072-1439; 2077-6624
• DOI: 10.21037/jtd-20-3595

Procedural setup is an important aspect of any procedure. Interventional pulmonologists provide a procedural practice and have additional expertise in performing high-risk procedures needed in the critically ill patients in intensive care. Taking the time to plan the procedure setup in advance and having all necessary equipment readily available at the patient’s bedside is imperative for procedural services. This is especially essential to ensure patient safety, minimize risk of complications, and improve success for specialized procedures performed by interventional pulmonary in the intensive care unit. In this review we describe the equipment and procedural setup ideal for both pleural and airway procedures. These include flexible diagnostic and therapeutic bronchoscopy, ultrasound guided thoracentesis, chest tube insertion, difficult airway management, and bedside percutaneous dilatation tracheostomy. We provide a guide checklist for these procedures emphasizing the practical aspects of each procedure from selecting the appropriate size endotracheal tube to operator positioning to ensure efficiency and best access. The components of procedural setup are discussed in relation to patient factors that include patient positioning and anesthesia, personnel in the procedure team and the equipment itself. We further briefly describe the additional equipment needed for specialized techniques in therapeutic bronchoscopy used by interventional pulmonologists.