Does central venous pressure predict fluid responsiveness?

However, the patient population studied in this previous report is different. These were patients with adenopathy not limited by size (mean size of lymph nodes sampled, 16 3.6 mm; range, 8 to 32 mm), complete mediastinal and hilar lymph node screening was not performed, and fewer nodes were sampled (mean, 1.14 per patient). These three differences would lead to reduced time and increased simplicity of the procedure, making it more amenable to moderate sedation. As more and more centers begin EBUS-TBNA programs, it is important that the procedure is performed in the correct environment and with realistic expectations of patients, operators, and equipment performance characteristics. If a consensus is reached that complete nodal staging is feasible and accurate with EBUS-TBNA, it may be more optimally performed under general anesthesia until the bronchoscopist feels comfortable in targeting these smaller lymph nodes in multiple stations in a conscious patient. We have recently described a safe option using propofol sedation with a laryngeal mask airway ventilation in the bronchoscopy suite that allows full access to the mediastinal lymph node stations.3 In contrast, EBUS-TBNA may be safely performed under conscious sedation in those patients with larger nodes without the requirement for complete lymph node staging.