Bronchoscopy in the intensive care unit.
The development of the flexible, fiberoptic bronchoscope has made bronchoscopic examinations possible in ICU patients undergoing mechanical ventilation. Over the years, the number of such procedures has greatly increased, with both diagnostic and therapeutic objectives, such as performing difficult intubation, management of atelectasis and hemoptysis, diagnosis of nosocomial pneumonia in ventilated patients, and early detection of airway lesions in selected situations, such as high-frequency ventilation. The complication rate can be kept low if the endoscopist has a precise knowledge of the many pathophysiological and technical facets particular to bronchoscopy under these difficult conditions. This article reviews some of these aspects, in the light of our personal experience.
Jolliet
P
P
Soins Intensifs de Médecine, Hôpital Cantonal Universitaire, Geneva, Switzerland.
Chevrolet
J C
JC
D001992:Bronchoalveolar Lavage Fluid; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods*; D003428:Cross Infection / Q000175:diagnosis; D006439:Hemodynamics; D006469:Hemoptysis / Q000175:diagnosis; D006611:High-Frequency Jet Ventilation; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D011014:Pneumonia / Q000175:diagnosis; D001261:Pulmonary Atelectasis / Q000628:therapy; D011652:Pulmonary Circulation; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial; D015656:Respiratory Mechanics; D012307:Risk Factors