Abstract：
OBJECTIVE: Fiberoptic bronchoscopy (FOB) is widely used in the intensive care unit for diagnostic and therapeutic purposes. Our study aimed to evaluate FOB\'s indications, complications, and clinical outcomes in our intensive care unit\'s mechanically ventilated patients and identify the microorganisms grown in bronchoalveolar lavage (BAL) specimens.
METHODS: Between January 1, 2022, and June 30, 2023, a total of 332 FOBs were performed on 178 patients in the respiratory intensive care unit.
RESULTS: Patients\' mean age was 64±19.4 years. Females accounted for 65 (36.6%) and males accounted for 113 (63.4%) of the cases. Leading diagnoses included pneumonia (59.5%), acute respiratory distress syndrome (ARDS) (20.7%), sepsis (17.9%), chronic obstructive pulmonary disease (COPD) attack (21.9%), pulmonary embolism (10.1%), lung malignancy (43.8%), hemoptysis (8.9%), heart failure (15.1%), neurological/neuromuscular conditions (8.4%), and post cardiopulmonary resuscitation (CPR) (2.8%). FOB purposes were BAL retrieval (43.6%), secretion clearance (30.4%), guided tracheostomy (11.7%), atelectasis (8.7%), and hemoptysis (5.4%). Hypoxemia marked the primary FOB complication (3.6%). Other issues encompassed hypotension (1.5%), bradycardia (1.2%), bleeding (1.2%), tachycardia (0.9%), and hypertension (0.6%). No statistical significance was found in arterial blood gas pH, arterial partial pressure of oxygen (PaO2), and arterial partial pressure of carbon dioxide (PaCO2) values before and after the FOB procedure (p>0.05). Predominant pathogens in aspiration samples were non-albicans Candida (28.9%), Klebsiella pneumoniae (24.8%), Pseudomonas aeruginosa (14.4%), and Acinetobacter baumannii (11.7%).
CONCLUSIONS: FOB is an important diagnostic and therapeutic method with a low complication rate when performed by an experienced team with appropriate indication in the intensive care unit.
METHODS: Between January 1, 2022, and June 30, 2023, a total of 332 FOBs were performed on 178 patients in the respiratory intensive care unit.
RESULTS: Patients\' mean age was 64±19.4 years. Females accounted for 65 (36.6%) and males accounted for 113 (63.4%) of the cases. Leading diagnoses included pneumonia (59.5%), acute respiratory distress syndrome (ARDS) (20.7%), sepsis (17.9%), chronic obstructive pulmonary disease (COPD) attack (21.9%), pulmonary embolism (10.1%), lung malignancy (43.8%), hemoptysis (8.9%), heart failure (15.1%), neurological/neuromuscular conditions (8.4%), and post cardiopulmonary resuscitation (CPR) (2.8%). FOB purposes were BAL retrieval (43.6%), secretion clearance (30.4%), guided tracheostomy (11.7%), atelectasis (8.7%), and hemoptysis (5.4%). Hypoxemia marked the primary FOB complication (3.6%). Other issues encompassed hypotension (1.5%), bradycardia (1.2%), bleeding (1.2%), tachycardia (0.9%), and hypertension (0.6%). No statistical significance was found in arterial blood gas pH, arterial partial pressure of oxygen (PaO2), and arterial partial pressure of carbon dioxide (PaCO2) values before and after the FOB procedure (p>0.05). Predominant pathogens in aspiration samples were non-albicans Candida (28.9%), Klebsiella pneumoniae (24.8%), Pseudomonas aeruginosa (14.4%), and Acinetobacter baumannii (11.7%).
CONCLUSIONS: FOB is an important diagnostic and therapeutic method with a low complication rate when performed by an experienced team with appropriate indication in the intensive care unit.
摘要：
目的：纤维支气管镜（FOB）在重症监护病房中广泛用于诊断和治疗目的。我们的研究旨在评估离岸价的适应症，并发症,和我们重症监护病房机械通气患者的临床结果，并确定支气管肺泡灌洗（BAL）标本中生长的微生物。
方法：在2022年1月1日至2023年6月30日之间，在呼吸重症监护病房的178名患者中共进行了332个FOB。
结果：患者的平均年龄为64±19.4岁。女性占65例（36.6%），男性占113例（63.4%）。主要诊断包括肺炎（59.5%），急性呼吸窘迫综合征（ARDS）（20.7%），脓毒症（17.9%），慢性阻塞性肺疾病（COPD）发作（21.9%），肺栓塞(10.1%),肺部恶性肿瘤（43.8%），咯血(8.9%),心力衰竭（15.1%），神经/神经肌肉疾病（8.4％），和心肺复苏后(CPR)(2.8%)。FOB目的是检索BAL(43.6%)，分泌清除率（30.4%），引导气管切开术（11.7%），肺不张(8.7%),和咯血(5.4%)。低氧血症是FOB的主要并发症（3.6%）。其他问题包括低血压（1.5％），心动过缓(1.2%),出血（1.2%），心动过速（0.9%），和高血压（0.6%）。动脉血气pH值无统计学意义,动脉氧分压（PaO2），FOB前后动脉二氧化碳分压(PaCO2)值(p>0.05)。吸入性标本中主要病原菌为非白色念珠菌(28.9%),肺炎克雷伯菌(24.8%),铜绿假单胞菌(14.4%),鲍曼不动杆菌(11.7%)。
结论：FOB是一种重要的诊断和治疗方法，在重症监护病房由具有适当适应症的经验丰富的团队进行时，并发症发生率低。
方法：在2022年1月1日至2023年6月30日之间，在呼吸重症监护病房的178名患者中共进行了332个FOB。
结果：患者的平均年龄为64±19.4岁。女性占65例（36.6%），男性占113例（63.4%）。主要诊断包括肺炎（59.5%），急性呼吸窘迫综合征（ARDS）（20.7%），脓毒症（17.9%），慢性阻塞性肺疾病（COPD）发作（21.9%），肺栓塞(10.1%),肺部恶性肿瘤（43.8%），咯血(8.9%),心力衰竭（15.1%），神经/神经肌肉疾病（8.4％），和心肺复苏后(CPR)(2.8%)。FOB目的是检索BAL(43.6%)，分泌清除率（30.4%），引导气管切开术（11.7%），肺不张(8.7%),和咯血(5.4%)。低氧血症是FOB的主要并发症（3.6%）。其他问题包括低血压（1.5％），心动过缓(1.2%),出血（1.2%），心动过速（0.9%），和高血压（0.6%）。动脉血气pH值无统计学意义,动脉氧分压（PaO2），FOB前后动脉二氧化碳分压(PaCO2)值(p>0.05)。吸入性标本中主要病原菌为非白色念珠菌(28.9%),肺炎克雷伯菌(24.8%),铜绿假单胞菌(14.4%),鲍曼不动杆菌(11.7%)。
结论：FOB是一种重要的诊断和治疗方法，在重症监护病房由具有适当适应症的经验丰富的团队进行时，并发症发生率低。
