[Effects of long-term ventilation on the bronchial system. Bronchoscopic, cytologic and microbiological findings].
The effects of longterm ventilation were evaluated in 50 patients from a medical intensive care unit. The bronchial tract was investigated using repeated bronchoscopy and assessed by semiquantitative scoring. Prior to each endoscopy tracheal secretions were obtained for microbiological and cytological evaluation, in 20 patients histological analysis of the bronchial mucosa was done in addition.


RESULTS
1. Within 24-48 hours after initiation of respirator ventilation alterations of the bronchial mucosa occur. The extent progresses rapidly, however no further increase of progression is to be observed after ventilation of approximately 150-200 hours. 2. Endoscopic assessment of the severity of mucosal changes correlates well with cytological and histologic results. 3. In 34 patients microbial agents could be demonstrated. In 8 of them mucosal changes preceded demonstration of microbial organisms. The extent of mucosal changes is independent of category or count of pathogen. Endoscopic follow-up investigations of the bronchial tract affected by long-term ventilation serve both direct bronchial clearing and control of position of the intubation tube as well as assessment of mucosal alterations and control of treatment of bronchial infection.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001980:Bronchi / Q000473:pathology*; D001999:Bronchoscopy; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000009:adverse effects*; D013997:Time Factors
Auswirkungen der Langzeitbeatmung auf das Bronchialsystem. Bronchoskopische, zytologische und mikrobiologische verlaufsuntersuchungen.