Book contents
- Frontmatter
- Contents
- Contributors
- Introduction
- Abbreviations/Acronyms
- 1 A Short History of Bronchoscopy
- 2 Multidetector Computed Tomography Imaging of the Central Airways
- 3 The Larynx
- 4 Airway Anatomy for the Bronchoscopist
- 5 Anesthesia for Bronchoscopy
- 6 Anatomy and Care of the Bronchoscope
- 7 Starting and Managing a Bronchoscopy Unit
- 8 Flexible Bronchoscopy: Indications, Contraindications, and Consent
- 9 Bronchial Washing, Bronchoalveolar Lavage, Bronchial Brush, and Endobronchial Biopsy
- 10 Transbronchial Lung Biopsy
- 11 Transbronchial Needle Aspiration
- 12 Bronchoscopy in the Intensive Care Unit
- 13 Bronchoscopy in the Lung Transplant Patient
- 14 Advanced Diagnostic Bronchoscopy
- 15 Basic Therapeutic Techniques
- Index
- References
12 - Bronchoscopy in the Intensive Care Unit
Published online by Cambridge University Press: 07 July 2009
Edited by
Book contents
- Frontmatter
- Contents
- Contributors
- Introduction
- Abbreviations/Acronyms
- 1 A Short History of Bronchoscopy
- 2 Multidetector Computed Tomography Imaging of the Central Airways
- 3 The Larynx
- 4 Airway Anatomy for the Bronchoscopist
- 5 Anesthesia for Bronchoscopy
- 6 Anatomy and Care of the Bronchoscope
- 7 Starting and Managing a Bronchoscopy Unit
- 8 Flexible Bronchoscopy: Indications, Contraindications, and Consent
- 9 Bronchial Washing, Bronchoalveolar Lavage, Bronchial Brush, and Endobronchial Biopsy
- 10 Transbronchial Lung Biopsy
- 11 Transbronchial Needle Aspiration
- 12 Bronchoscopy in the Intensive Care Unit
- 13 Bronchoscopy in the Lung Transplant Patient
- 14 Advanced Diagnostic Bronchoscopy
- 15 Basic Therapeutic Techniques
- Index
- References
Summary
In the future, as at present, the internist will tap and look and listen on the outside of the chest…; the roentgenologist will continue to look through the patient; but in a continually increasing proportion of cases, the surgeon, the internist and the roentgenologist will ask the bronchoscopist to look inside the patient.
– Chevalier Jackson, MD 1928INTRODUCTION
Pulmonologists and surgeons are frequently called on to perform bronchoscopy on critically ill patients in the intensive care unit (ICU). The ease, safety, and portability of bronchoscopy make it one of the most commonly requested invasive procedures in the ICU setting. Flexible bronchoscopy (first fiber optic and now video) was introduced by Dr. Ikeda of Japan in the late 1960s and became more widely available in the mid to late 1970s. Now, with advances in technology allowing for greater portability, bronchoscopy has become ubiquitous in the modern hospital.
The ease of availability of bronchoscopy to intensivists has broadened the pulmonary diagnostic and therapeutic capabilities in critically ill patients, but like many technologies it also raises certain challenges in its appropriate application. Technology is not a substitute for good clinical judgment; operators must assess patient safety and perform procedures with attention to patient comfort and knowledge of potential complications and a management plan for complications including respiratory failure, pneumothorax, and so on.
In this chapter, I hope to outline the most common consultations and appropriate uses for bronchoscopy in the ICU.
Information
- Type
- Chapter
- Information
- Introduction to Bronchoscopy , pp. 115 - 125Publisher: Cambridge University PressPrint publication year: 2009
References
, . Ventilator-associated pneumonia. Am J Respir Crit Care Med. 2002;165:867–903.CrossRefGoogle ScholarPubMed
, , , . Bronchoscopic removal of foreign bodies in adults: experience with 62 patients from 1974–1998. Eur Respir J. 1999;14(4):792–795.CrossRefGoogle Scholar
, , , et al. Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia. Ann Intern Med. 2000;132:621–630.CrossRefGoogle ScholarPubMed
, . Clinical efficacy of early and delayed fiberoptic bronchoscopy in patients with hemoptysis. Am Rev Respir Dis. 1981;124:221–225.Google ScholarPubMed
, , , et al. Utility of fiberoptic bronchoscopy in neutropenic patients admitted to the intensive care unit with pulmonary infiltrates. Crit Care Med. 2000;28:2224–2230.CrossRefGoogle ScholarPubMed
, , , , , . Safety of bronchoalveolar lavage in the critically ill, mechanically ventilated patient. Crit Care Med. 1991;19(12):1526–1532.CrossRefGoogle ScholarPubMed
, , , . Utility of bronchoalveolar lavage for the diagnosis of ventilator-associated pneumonia in critically ill surgical patients. Am J Surg. 2008;195:159–163.CrossRefGoogle Scholar
, . Bronchoscopy for atelectasis in the intensive care unit: a case report and review of the literature. Chest. 2003;124:344–350.CrossRefGoogle ScholarPubMed
. Non-asphyxiating tracheobronchial foreign bodies in adults. Eur Respir J. 1994;7(3):510–514.CrossRefGoogle ScholarPubMed
, , . Acute lobar atelectasis: a prospective comparison of fiberoptic bronchoscopy and respiratory therapy. Am Rev Respir Dis. 1979;119:971–978.Google ScholarPubMed
, , , , . Effects of consecutive protected specimen brushing and bronchoalveolar lavage on gas exchange and hemodynamics in ventilated patients. Chest. 1993;104:1548–1552.CrossRefGoogle ScholarPubMed
, . Hemoptysis: a clinical evaluation of 105 patients examined consecutively on a thoracic surgical service. Am Rev Respir Dis. 1961;84:329–336.Google ScholarPubMed
, . Adult airway foreign body removal. What's new? Clin Chest Med. 2001;22(2):319–330.CrossRefGoogle ScholarPubMed
, , , . Flexible fiberoptic bronchoscopy and endobronchial tamponade in the management of massive hemoptysis. Chest. 1976;70:589–591.CrossRefGoogle ScholarPubMed
, , , , . Safety of bronchoalveolar lavage in patients with adult respiratory distress syndrome. Am Rev Respir Dis. 1993;148:556–561.CrossRefGoogle ScholarPubMed
Accessibility standard: Unknown
Why this information is here
This section outlines the accessibility features of this content - including support for screen readers, full keyboard navigation and high-contrast display options. This may not be relevant for you.Accessibility Information
Accessibility compliance for the PDF of this chapter is currently unknown
and may be updated in the future.
- 1
- Cited by