IS FLEXIBLE BRONCHOSCOPY A SAFE PROCEDURE FOR CRITICAL CARE PATIENTS WITH RESPIRATORY FAILURE?

• Published in: Acta clinica Croatica (Tisak) Vol. 62; no. 2; pp. 291 - 299
• Main Authors: Kaya, Aslıhan Gürün, Öz, Miraç, Dilegelen, Umut, Ecer, Duygu, Erol, Serhat, Çiftçi, Fatma, Çiledağ, Aydın, Kaya, Akın
• Format: Journal Article
• Language: English
• Published: Croatia Sestre Milosrdnice University Hospital and Institute of Clinical Medical Research, Vinogradska cesta c. 29 Zagreb 01.01.2023; Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
• Subjects: Bronchoscopy; Bronchoscopy - adverse effects; Bronchoscopy - methods; Complication; Critical Care; Humans; Original Scientific Papers; Respiration, Artificial; Respiratory failure; Respiratory Insufficiency - etiology; Respiratory Insufficiency - therapy; Respiratory support; Retrospective Studies; Bronchoscopy; Critical care; Complication; Respiratory failure; Respiratory support
• ISSN: 0353-9466; 1333-9451
• DOI: 10.20471/acc.2023.62.02.06

Flexible bronchoscopy (FB) plays an important role in critical care patients. But, critical care patients with respiratory failure are at an increased risk of developing complications. Considering the developments in intensive care unit care in recent years, we aimed to evaluate the use of FB in these patients. We retrospectively reviewed patients who underwent FB in critical care between 2014 and 2020. A total of 143 patients underwent FB during the study period. Arterial blood gas measurement on the FB day revealed a mean PaO /FiO of 186.94±28.47. Eighty-one (56.6%) patients underwent an fiberoptic bronchoscopy procedure under conventional oxygen supplementation, 10 (7%) on noninvasive ventilation, 13 (9.1%) on high flow nasal cannula, and 39 (27.3%) on invasive mechanical ventilation. During and immediately after bronchoscopy, none of the patients experienced life-threatening complications. Fifty-five (38.5%) patients developed complications that could be controlled. Multivariate analysis indicated that increased Apache-II score and presence of cardiovascular disease were significantly associated with an increased complication risk. Although critical care patients with respiratory failure are more prone to complications, diagnostic and therapeutic bronchoscopy may be performed following appropriate patient selection, without leading to major complications.