Survey on Bronchoscopy in Intensive Care Unit

<bold>Introduction:</bold> Flexible bronchoscopy (FB) has been of great help in the management of critically ill patients on intensive care unit (ICU). However, little is known about daily practice in ICU across Europe. <bold>Methods:</bold> From 05/2023 to 12/2023, the acute critical group of ERS performed an internet-based survey to analyze FB practice on ICU across Europe. The survey was disseminated by the assembly heads and consisted of demographics, and FB data. <bold>Results:</bold> Full data sets were available in 266 participants from 73 different countries worldwide. Most participants were male (64%) between 35 and 44 years old (43%) and worked as consultants (55%) in a university hospital (63%). FB (fiber-optic bronchoscopes in 61%) was supported by a trained assistance in 54%. 11% of participants reported that they decline FB due to economic reasons. Beside EKG, oximetry and blood pressure measurements information about imaging, platelet count and prothrombin time was demanded pre-FB in 90%, 82% and 69%. Ventilators were set to pressure- or volume-controlled mode in 34% each with an increase of FiO2 (94%). PEEP was reduced by 48% of participants during FB. Main indication for FB was secretion with subsequent microbiological testing. Most used either BAL (43%) or suctioning with adding saline (40%). Recovery was reported to be 48±18%. Microbiological testing included bacterial assessment (100%), viral assessment (68%, multiplex PCR) or aspergillus-antigen (73%). Microbiological assessment changed therapeutic regimen in 48±21%. <bold>Conclusion:</bold> FB might help to customize therapy in critically ill patients. However, FB practice varies much across the world. Thus, a guideline and expert review of the current status of FB in ICU is necessary.