Bedside pleuroscopy in the Intensive Care Unit

OBJECTIVES: It is not always possible to move critically ill patients to the operating or endoscopy room for a pleuroscopy. Bedside pleuroscopy is indicated for these patients. The aim of this study was to investigate the safety and complications of bedside pleuroscopy in an Intensive Care Unit (ICU). MATERIALS AND METHODS: The patients who had undergone routine examinations for pleural effusion, with no established diagnosis at the previous admission were included in this analysis. Patients received local analgesia with bedside pleuroscopy performed by a chest physician in the ICU with continuous monitoring. RESULTS: Twenty-five patients (17 males and 8 females) with a mean age of 74 ± 3 years were enrolled. Their mean APACHE II score was 23 ± 1. The duration of drainage from the pigtail catheter was a mean 3.9 ± 0.2 days, and mean ventilator usage was 6 ± 0.7 days. The length of stay in the ICU was 11 ± 1 days. Most pleural effusions occurred on the right side (17/25, 68%). Fifteen patients (60%) had malignant effusions, four (16%) had parapneumonic effusions, three (12%) had empyema, and two (8%) had tuberculosis. Complications occurred in 11 (44%) patients. There were no major complications such as bleeding or procedure-related death. The most common complication was transient chest pain (n = 6, 24%). CONCLUSIONS: Pleuroscopy performed at the bedside in the ICU is a simple and safe procedure. It has the potential for use in critical patients as serious complications are rare.