Carbon dioxide laser bronchoscopy: a review of problems and complications

The records of 20 patients who underwent carbon dioxide laser bronchoscopy were analysed retrospectively. Many of the cases presented with evidence of severe obstruction of the trachea or major bronchi and were regarded as highly at risk from anaesthesia. The majority of problems in the 35 laser sessions related to the use of a rigid bronchoscope for delivering the laser and to the ventilatory difficulties associated with the airway pathology. Invasive arterial monitoring for blood gas analysis and blood pressure measurement proved essential to detect and correct changes of a potentially serious nature. This experience is compared and contrasted with that of others.