Role of Bronchoscopy in Difficult to Wean Patients

INTRODUCTION: Bronchoscopy is an important tool for pulmonary and critical care physicians to diagnose as well as treat various pulmonary diseases. In the intensive care unit (ICU), due to its safety and portability, bronchoscopy plays a significant diagnostic and therapeutic role in critically ill patients who cannot be transported to the remote imaging or diagnostic units. It can also help to treat several conditions including airway obstruction, foreign bodies, haemoptysis, mucus plugging, and others. OBJECTIVES: to study and evaluate the need for bronchoscopy in difficult to wean patients admitted in the ICU. MATERIALS AND METHODS: A prospective study conducted over a period of 6 months on 70 patients who where admitted in the Intensive Care Unit. INCLUSION-patients difficult to wean off the ventilator, patients with Non-resolving pneumonia, haemodynamically stable patient. EXCLUSION-haemodynamically unstable patients, patients on high ventilator support. RESULTS: Patients who had undergone bronchoscopy showed varied results. Among 70 bronchoscopies,40(57%) showed thick secretions.15(21%) showed fungal growth. 11(15%) had an underlying mass lesion. Only 4(5%) had a finding of diffuse alveolar haemorrhage.(1–3) DISCUSSIONS/CONCLUSIONS: This study concluded that bronchoscopy in ICU provides valuable diagnostic information and sometimes also has therapeutic utility. Although it is not advisable in patient on high ventilator support and haemodynamically unstable patients.