Do you routinely perform a pre-extubation bronchoscopy for secretion clearance during the index hospitalization in patients following lung transplantation?

Yes, this is routinely done on post-op day 1 and frequently repeated if the patient is not extubated on the first post-operative day after lung transplantation. This is typically necessary and done early in the post-op phase to clear out blood or debris from the airway that often accumulates in the tracheobronchial tree due to ischemic lung injury to the bronchial mucosa after lung transplantation. This is an inherent risk associated with cold ischemic time accrued after procurement and before r...

I do not routinely perform a pre-extubation bronchoscopy for secretion clearance after lung transplant. In routine cases, a bronchoscopy is performed on the donor lungs prior to acceptance of the donor, just prior to explantation of lungs from the donor, and at the end of the case after implantation of the lungs in the recipient. Within 24 hours, the patient is allowed to wake up and be assessed for extubation. Instead of delaying extubation to perform bronchoscopy and wait for the recipient to ...