title: [Fiberoptic bronchoscopy in a respiratory intensive care unit].
abstract: OBJECTIVE
  To describe the indications, diagnostic performance and safety of fiberoptic bronchoscopy (FOB) performed in a respiratory intensive care unit (RICU).
  
  
  METHODS
  A prospective, observational study was carried out.
  
  
  METHODS
  A 6-bed RICU in a tertiary university hospital.
  
  
  METHODS
  Patients admitted to RICU who required FOB.
  
  
  METHODS
  None.
  
  
  METHODS
  FOB indications and complications, endoscopic procedures, time required to perform FOB.
  
  
  RESULTS
  Sixty-nine out (23%) of the 297 patients admitted to the RICU underwent a total of 107 FOB. Sixty-eight percent of FOB were performed in patients on mechanical ventilation. FOB was performed for diagnostic and therapeutic purposes in 88 (82%) and 19 cases (18%), respectively. The study of pulmonary infiltrates was the main indication for diagnostic FOB (44 cases; 50%), particularly in immunocompromised patients (24 cases; 27%). In immunocompromised patients the diagnostic performance of FOB was significantly higher than in immunocompetent subjects (48% vs 30%; p<0.01). No major complications were recorded. Only a significant drop in PaO(2)/FiO(2) ratio was observed (182 ± 74 vs 163 ± 79; p<0.005) in patients undergoing bronchoalveolar lavage. Overall mortality in patients in the RICU was 14%. In patients requiring a single FOB procedure, mortality was 25%, versus 45% among those requiring more than one FOB procedure.
  
  
  CONCLUSIONS
  These results show that FOB is used commonly in the RICU. It is a safe and fast procedure that contributes significantly to clinical management. Patients requiring additional FOB during admission to the RICU show high mortality.
authors.affiliation: Servicio de Neumología, Instituto Clínico del Tórax, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Ciber de Enfermedades Respiratorias, España.
authors.forename: C M
authors.initials: CM
authors.lastname: Lucena
authors.forename: P
authors.initials: P
authors.lastname: Martínez-Olondris
authors.forename: J R
authors.initials: JR
authors.lastname: Badia
authors.forename: A
authors.initials: A
authors.lastname: Xaubet
authors.forename: M
authors.initials: M
authors.lastname: Ferrer
authors.forename: A
authors.initials: A
authors.lastname: Torres
authors.forename: C
authors.initials: C
authors.lastname: Agustí
mesh_terms: D000368:Aged; D001706:Biopsy / Q000379:methods; D001992:Bronchoalveolar Lavage Fluid; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation*; D017052:Hospital Mortality; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012121:Respiration, Artificial; D012124:Respiratory Care Units / Q000379:methods*; D012140:Respiratory Tract Diseases / Q000175:diagnosis* / Q000601:surgery*; D012680:Sensitivity and Specificity; D062606:Tertiary Care Centers