Fibreoptic bronchoscopy in the critically ill: a prospective study of its diagnostic and therapeutic value.
OBJECTIVE
A prospective study was undertaken to assess the diagnostic value and therapeutic usefulness of fibreoptic bronchoscopy in the critically ill.


METHODS
Fifty-six bronchoscopies were performed in fifty patients. Biochemical, radiological, microbiological and clinical assessments were made before and after each procedure.


RESULTS
Eighteen fibreoptic bronchoscopies were performed for therapeutic indications (32.1%) of which ten (55.6%) yielded a useful outcome. Thirty-eight bronchoscopies were for diagnostic purposes (67.8%) of which 22 (57.9%) were clinically useful. Broncho-alveolar lavage was performed in twenty-eight cases (50%) and it led to a clinically useful diagnosis in 17 (60.7%). There was no major complication. A subgroup of patients was defined (persistent left lower lobe collapse or consolidation following thoracic or abdominal surgery) in whom fibreoptic bronchoscopy usually did not yield a useful outcome.


CONCLUSIONS
The use of fibreoptic bronchoscopy in the Intensive Care Unit, in combination with the technique of broncho-alveolar lavage, results in a clinically useful outcome in the majority of cases. Fibreoptic bronchoscopy is an effective and safe diagnostic and therapeutic tool in critically ill patients.
Bellomo
R
R
Department of Respiratory Medicine, Monash Medical Centre, Melbourne, Victoria, Australia.
Tai
E
E
Parkin
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D001999:Bronchoscopy; D016638:Critical Illness / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D007507:Therapeutic Irrigation