Evaluation of bronchofibroscopy in na intensive care unit

Abstract

Background: Fibre-optic bronchoscopy (FBC) has been described
as a useful technique for the study of respiratory disease in the
Intensive Care Unit (ICU). We designed the present study to evaluate the diagnostic potential and the therapeutic implications of
FBC in our ICU.
Methods: Retrospective study of 95 FBC performed in a medico-surgical ICU. Indications, complication rate, endoscopic findings,
additional studies performed during endoscopy, microbiologic
studies and their implication in antibiotherapy were evaluated.
Findings: FBC was performed to evaluate pneumonia in 48
cases, atelectasis in 24 and aspiration pneumonia in 21 cases.
Identifi cation of an infectious agent in patients with pneumonia
was achieved in 32 cases resulting in an antibiotic regimen
change in 26 of them. Atelectasis was confirmed in 20 of the
24 cases and aspiration pneumonia in only 3 cases. Mucosal
infl ammation and bronchial secretions were the most common
endoscopic findings and complication rate was low (transitory hypoxaemia in 10 cases).
Conclusions: FBC is an endoscopic technique with a low rate of
complications and can be very useful in the study of pulmonary
disease in mechanically ventilated patients. The diagnostic and
therapeutic potential of FBC depends mostly on careful patient selection.