ICU Bronchoscopy
First Things First (assess & treat for the following)
- Does pt have an indication for ICU bronchoscopy?
- Indications are the same as for non-ICU bronchoscopy.
- Diagnostic (most common ICU indications)
- Hemoptysis/hemostasis
- Diffuse parenchymal infiltrates of unknown etiology
- Unresolving infiltrate
- Acute inhalation injury
- Chest traumatic airways injuries (exclude fractured airway)
- Infection/ventilator-associated pneumonia
- Assessment of ETT placement
- Undiagnosed lung mass w/ associated respiratory failure
- Evaluation of bleeding or pneumothorax after lung resection
- Therapeutic (most common ICU indications)
- Lobar or segmental atelectasis
- Retained secretions or mucous plugging
- Unresponsive to chest physiotherapy
- Facilitate endotracheal intubation in difficult airways
- Extract foreign bodies
- Closure of bronchopleural fistulas
- Central obstructing lesions
- Assist w/ percutaneous dilational tracheostomy
- Lobar or segmental atelectasis
- Does pt have a contraindication for ICU bronchoscopy?
- Unable to obtain informed consent/patient refusal
- Experienced personnel unavailable
- Refractory hypoxemia
- Uncorrectable coagulopathy when biopsies (forceps or brush) are planned
- Unstable arrhythmias or active ischemia
- Refractory hypotension
- Uncontrolled bronchospasm
- Flexible vs. rigid bronchoscopy?
- Several advantages to flexible bronchoscopy
- Easier
- Fewer complications
- More comfortable for patient
- Better visualization of entire tracheobronchial tree
- Does not require general anesthesia
- Relative indications for rigid bronchoscopy
- Brisk hemoptysis (>200 mL/24 hrs)
- Pediatric or large foreign bodies
- Obstructing lesions of major airways
- Several advantages to flexible bronchoscopy
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Last updated: May 5, 2010
Citation
"ICU Bronchoscopy." Pocket ICU Management, PocketMedicine.com, Inc, 2010. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534139/all/ICU_Bronchoscopy.
ICU Bronchoscopy. Pocket ICU Management. PocketMedicine.com, Inc; 2010. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534139/all/ICU_Bronchoscopy. Accessed December 11, 2024.
ICU Bronchoscopy. (2010). In Pocket ICU Management. PocketMedicine.com, Inc. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534139/all/ICU_Bronchoscopy
ICU Bronchoscopy [Internet]. In: Pocket ICU Management. PocketMedicine.com, Inc; 2010. [cited 2024 December 11]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534139/all/ICU_Bronchoscopy.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - ICU Bronchoscopy
ID - 534139
Y1 - 2010/05/05/
BT - Pocket ICU Management
UR - https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534139/all/ICU_Bronchoscopy
PB - PocketMedicine.com, Inc
DB - Anesthesia Central
DP - Unbound Medicine
ER -