title: Role of Bronchoscopy in Prompt Discharge From the Intensive Care Unit.
abstract: BACKGROUND
  Intensive care unit (ICU) stays are 2.5 times more costly than other hospital stays, and 93.3% of ICU use is for respiratory disease with ventilator support. The aim of this study was to assess the role of bronchoscopy on discontinuation of mechanical ventilation, and prompt discharge from ICU in our institution.
  
  
  METHODS
  Retrospective review of medical records of patients referred for bronchoscopic intervention for acute respiratory failure from malignant or benign central airway diseases requiring ICU admission.
  
  
  RESULTS
  Twelve critically ill patients were studied. Median (range) age was 63 years (range, 35 to 85 y). Nine (75%) had endotracheal tube, and 3 (25%) had tracheostomy tube. Nine (75%) of 12 patients admitted to ICU could be transferred to general ward after median (range) interval of 2 days (range, 1 to 7 d) after the day of intervention. Median (range) prebronchoscopy and postbronchoscopy PaO2/FiO2 ratio was 102.8 (range, 99.2 to 328) and 180 (range, 129 to 380), respectively, with significant improvement postintervention (P=0.002). Radiologically, all 8 patients with lung atelectasis on presentation experienced complete reexpansion of the lung on the day after bronchoscopic intervention.
  
  
  CONCLUSIONS
  The majority of patients in our cohort (75%) of benign and malignant etiology could be promptly (within 2 d postbronchoscopy) transferred out from ICU to general ward after successful discontinuation of mechanical ventilation and extubation after bronchoscopic intervention. We advocate early recognition and bronchoscopic intervention in suitable patients.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore.
authors.forename: Akash
authors.initials: A
authors.lastname: Verma
authors.forename: Wen Yuan
authors.initials: WY
authors.lastname: Sim
authors.forename: Dessmon Y H
authors.initials: DY
authors.lastname: Tai
authors.forename: Soon Keng
authors.initials: SK
authors.lastname: Goh
authors.forename: Ai Ching
authors.initials: AC
authors.lastname: Kor
authors.forename: Chee Kiang
authors.initials: CK
authors.lastname: Phua
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ho
authors.forename: Albert Y H
authors.initials: AY
authors.lastname: Lim
authors.forename: Sennen J W
authors.initials: SJ
authors.lastname: Lew
authors.forename: Huiying
authors.initials: H
authors.lastname: Xu
authors.forename: Ser Hon
authors.initials: SH
authors.lastname: Puah
authors.forename: John
authors.initials: J
authors.lastname: Abisheganaden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060666:Airway Extubation / Q000379:methods*; D001999:Bronchoscopy / Q000379:methods*; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000379:methods*