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Bronchoscopy in intubated and non-intubated intensive care unit patients with respiratory failure

Bronchoscopy is one of the important tool for the pulmonary and critical care physicians to diagnose and treat various pulmonary conditions. It is increasingly being used by the intensivist due to its safety and portability. The utilization of bronchoscopy in the intensive care unit (ICU) has made t...

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Autores principales: Patolia, Setu, Farhat, Rania, Subramaniyam, Rajamurugan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411155/
https://www.ncbi.nlm.nih.gov/pubmed/34527353
http://dx.doi.org/10.21037/jtd-19-3709
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author Patolia, Setu
Farhat, Rania
Subramaniyam, Rajamurugan
author_facet Patolia, Setu
Farhat, Rania
Subramaniyam, Rajamurugan
author_sort Patolia, Setu
collection PubMed
description Bronchoscopy is one of the important tool for the pulmonary and critical care physicians to diagnose and treat various pulmonary conditions. It is increasingly being used by the intensivist due to its safety and portability. The utilization of bronchoscopy in the intensive care unit (ICU) has made the diagnosis and treatment of many conditions more feasible to intensivists. Sedation, topical or intravenous, usually helps better tolerate the procedure. However, the risks and benefits of bronchoscopy should be carefully considered in critically ill patients. The hypoxic patients in ICU pose a challenge as hypoxemia is one of the known complications of bronchoscopy, and this risk is exacerbated in patients with hypoxic respiratory failure. Bronchoscopy is relatively contraindicated in patients with severe hypoxemia and coagulopathy. However, bronchoscopy in hypoxic patients can have diagnostic as well as therapeutic implications. In patients with hypoxic respiratory failure, the use of non-invasive ventilation (NIV) during bronchoscopy has been shown to reduce the risk of intubation. On the other hand, bronchoscopy in mechanically ventilated patients is not contraindicated and has been widely used. Staying focused, monitoring vital signs closely, limiting the scope time in the airway, and understanding patient’s physiology may help decrease risk of complications. In this review, we discuss indications, techniques, complications, and yield associated with bronchoscopy in critically ill hypoxic patients.
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spelling pubmed-84111552021-09-14 Bronchoscopy in intubated and non-intubated intensive care unit patients with respiratory failure Patolia, Setu Farhat, Rania Subramaniyam, Rajamurugan J Thorac Dis Review Article on Interventional Pulmonology in the Intensive Care Unit Bronchoscopy is one of the important tool for the pulmonary and critical care physicians to diagnose and treat various pulmonary conditions. It is increasingly being used by the intensivist due to its safety and portability. The utilization of bronchoscopy in the intensive care unit (ICU) has made the diagnosis and treatment of many conditions more feasible to intensivists. Sedation, topical or intravenous, usually helps better tolerate the procedure. However, the risks and benefits of bronchoscopy should be carefully considered in critically ill patients. The hypoxic patients in ICU pose a challenge as hypoxemia is one of the known complications of bronchoscopy, and this risk is exacerbated in patients with hypoxic respiratory failure. Bronchoscopy is relatively contraindicated in patients with severe hypoxemia and coagulopathy. However, bronchoscopy in hypoxic patients can have diagnostic as well as therapeutic implications. In patients with hypoxic respiratory failure, the use of non-invasive ventilation (NIV) during bronchoscopy has been shown to reduce the risk of intubation. On the other hand, bronchoscopy in mechanically ventilated patients is not contraindicated and has been widely used. Staying focused, monitoring vital signs closely, limiting the scope time in the airway, and understanding patient’s physiology may help decrease risk of complications. In this review, we discuss indications, techniques, complications, and yield associated with bronchoscopy in critically ill hypoxic patients. AME Publishing Company 2021-08 /pmc/articles/PMC8411155/ /pubmed/34527353 http://dx.doi.org/10.21037/jtd-19-3709 Text en 2021 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article on Interventional Pulmonology in the Intensive Care Unit
Patolia, Setu
Farhat, Rania
Subramaniyam, Rajamurugan
Bronchoscopy in intubated and non-intubated intensive care unit patients with respiratory failure
title Bronchoscopy in intubated and non-intubated intensive care unit patients with respiratory failure
title_full Bronchoscopy in intubated and non-intubated intensive care unit patients with respiratory failure
title_fullStr Bronchoscopy in intubated and non-intubated intensive care unit patients with respiratory failure
title_full_unstemmed Bronchoscopy in intubated and non-intubated intensive care unit patients with respiratory failure
title_short Bronchoscopy in intubated and non-intubated intensive care unit patients with respiratory failure
title_sort bronchoscopy in intubated and non-intubated intensive care unit patients with respiratory failure
topic Review Article on Interventional Pulmonology in the Intensive Care Unit
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411155/
https://www.ncbi.nlm.nih.gov/pubmed/34527353
http://dx.doi.org/10.21037/jtd-19-3709
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