Experience With the Use of Single-Use Disposable Bronchoscope in the ICU in a Tertiary Referral Center of Singapore.
BACKGROUND
Flexible bronchoscopy is performed frequently in intensive care units (ICUs) for various indications using the reusable conventional bronchoscope (CB). Recently, "single-use disposable bronchoscope" (SB) was introduced into the health care industry. The purpose of this study was to compare the utility of SB with CB in ICU.


METHODS
A retrospective review of medical records of patients undergoing flexible bronchoscopy in the ICUs in the year 2015.


RESULTS
Ninety-three patients undergoing flexible bronchoscopy in the ICU were studied. Eighty-three bronchoscopies were performed using SB in 71 patients, and 24 using CB in 22 patients. The most common indications for using the SB were percutaneous tracheostomy [n=37 (44.6%)] in neuro-ICU, followed by collecting specimens for microbiological evaluation [n=20 (24.1%)] in the medical ICU. Airway inspection [8 (9.6%)], bronchial toilet [8 (9.6%)], hemoptysis [5 (6%)], and intubation [3 (3.6%)] were other indications for which SB was used. Microbiological yield of SB was 70% (14/20) versus 70% (7/10) for CB (P=1.0). The median interval between identification of the need-to-start of the procedure was shorter with SB (10 min) versus CB (66 min, P=0.01), whereas the cost was similar, SGD450 versus SGD472, respectively. In addition, less (3 personnel) were needed to perform bronchoscopy with SB versus 5 with CB with additional resource sparing effect in terms of nursing personnel having to wheel the CB equipment to ICU.


CONCLUSIONS
SB is equivalent in performance to CB in ICU. In addition, the SB may confer clinical, economic, and logistical advantages over the CB.
*Department of Medicine, Imperial College London, London, UK †Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
Dominic C
DC
Marshall
Rucha S
RS
Dagaonkar
Chan
C
Yeow
Anura T
AT
Peters
Siew Kin
SK
Tan
Dessmon Y H
DY
Tai
Soon
S
Keng Gohs
Albert Y H
AY
Lim
Benjamin
B
Ho
Sennen J W
SJ
Lew
John
J
Abisheganaden
Akash
A
Verma
D000368:Aged; D001999:Bronchoscopy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012846:Singapore; D062606:Tertiary Care Centers; D014139:Tracheostomy / Q000295:instrumentation*