The purpose of this study is to use transesophageal echocardiography (TEE) to determine the incidence, severity, and clinical significance of gas bubbles during argon plasma coagulation (APC).

Gas embolism is a rare but serious complication of APC. We will use TEE to monitor for gas bubbles during APC. APC will be terminated if gas bubbles are associated with ischemic heart rhythms, wall motion abnormalities, or if large gas bubbles are noted in the left ventricle.

Inclusion Criteria:

• Adults (male and female) 18 years of age or older
• Clinical indication for bronchoscopy (hemoptysis, airway obstruction, tumor excision, granulation tissue that is impairing endobronchial stent performance)
• Ability of the patient or proxy to read, comprehend, and sign informed consent document.

Exclusion Criteria:

• Presence of esophageal disorders that may complicate transesophageal echocardiography (strictures, varices, fistula, prior esophageal surgery)
• Presence of coagulopathy or other bleeding diathesis
• Inability to tolerate brief periods of apnea
• Presence of pulmonary vascular disease
• Pregnant women will not be included in this study because the potential fetal hypoxemia is not an acceptable risk.
• No exclusions will be made based on gender or race.

patients referred to tertiary care center

IPD was not shared