AI Article Synopsis
- The study assessed fiberoptic bronchoscopy (FOB) use in mechanically ventilated ICU patients, examining indications, complications, and outcomes, analyzing 332 procedures performed on 178 patients over 18 months.
- The most common diagnoses were pneumonia, acute respiratory distress syndrome, and lung malignancies, with the primary FOB purposes being bronchoalveolar lavage, secretion clearance, and guided tracheostomy.
- Complications were mostly mild, with hypoxemia being the most frequent, and predominant pathogens identified included non-albicans Candida, Klebsiella pneumoniae, and Pseudomonas aeruginosa; overall, FOB showed a low complication rate and is beneficial for patient management
Article Abstract
Objective: Fiberoptic bronchoscopy (FOB) is widely used in the intensive care unit for diagnostic and therapeutic purposes. Our study aimed to evaluate FOB's indications, complications, and clinical outcomes in our intensive care unit's mechanically ventilated patients and identify the microorganisms grown in bronchoalveolar lavage (BAL) specimens.
Patients And Methods: Between January 1, 2022, and June 30, 2023, a total of 332 FOBs were performed on 178 patients in the respiratory intensive care unit.
Results: Patients' mean age was 64±19.4 years. Females accounted for 65 (36.6%) and males accounted for 113 (63.4%) of the cases. Leading diagnoses included pneumonia (59.5%), acute respiratory distress syndrome (ARDS) (20.7%), sepsis (17.9%), chronic obstructive pulmonary disease (COPD) attack (21.9%), pulmonary embolism (10.1%), lung malignancy (43.8%), hemoptysis (8.9%), heart failure (15.1%), neurological/neuromuscular conditions (8.4%), and post cardiopulmonary resuscitation (CPR) (2.8%). FOB purposes were BAL retrieval (43.6%), secretion clearance (30.4%), guided tracheostomy (11.7%), atelectasis (8.7%), and hemoptysis (5.4%). Hypoxemia marked the primary FOB complication (3.6%). Other issues encompassed hypotension (1.5%), bradycardia (1.2%), bleeding (1.2%), tachycardia (0.9%), and hypertension (0.6%). No statistical significance was found in arterial blood gas pH, arterial partial pressure of oxygen (PaO2), and arterial partial pressure of carbon dioxide (PaCO2) values before and after the FOB procedure (p>0.05). Predominant pathogens in aspiration samples were non-albicans Candida (28.9%), Klebsiella pneumoniae (24.8%), Pseudomonas aeruginosa (14.4%), and Acinetobacter baumannii (11.7%).
Conclusions: FOB is an important diagnostic and therapeutic method with a low complication rate when performed by an experienced team with appropriate indication in the intensive care unit.
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| http://dx.doi.org/10.26355/eurrev_202402_35465 | DOI Listing |
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