Evaluation of the role of bronchoscopy in the intensive care units

Abstract

Objectives: The aim of this study was to evaluate the role of bronchoscopy in the intensive care units (indications, advantages, disadvantages, results, and complications). Patients and methods: Bronchoscopy (rigid or fibroptic) was performed in Ain shams University hospital and Ain Shams University Specialized Hospitals on 80 ICU patients requiring diagnostic and/or therapeutic indication. The patients were grouped into ventilated and nonventilated. Results: A total of 50 (62%) fibroptic bronchoscopies and 30 (37%) rigid bronchoscopies were performed on 30 (37.5%) ventilated patients and 50 (62.5%) nonventilated. Overall, 90% of flexible bronchoscopies were done for ventilated patients and 54% of rigid bronchoscopies was done in nonventilated patients (54%). Moreover, 80% of the procedures were done for diagnostic purposes using fibroptic bronchoscopies in 98%, whereas 36.7% of bronchoscopies were done for combined indications and 13.3% of therapeutic indications bronchoscopies were done with rigid bronchoscopy. In addition, 51.25% of the procedures that were done with bronchoscopies were lavage followed by stent insertion (25%). In 83.3% of ventilated patients, lavage was done, whereas stent insertion was more in nonventilated patient group. Overall, 26.25% of the patients were diagnosed as having malignant disease and 20% had infections of lower respiratory tract. Complications occurred in 21.25%, with mortality rate of 0.0%, and hypoxia was the most common. Conclusion: Safety is one of the most important issues when deciding to perform bronchoscopy in the ICU, which depends on the accuracy of selection of the patients for the procedure and the experience of the bronchoscopist and facilities available.