• Akash Verma, Wen Yuan Sim, Dessmon Y H Tai, Soon Keng Goh, Ai Ching Kor, Chee Kiang Phua, Benjamin Ho, Albert Y H Lim, Sennen J W Lew, Huiying Xu, Ser Hon Puah, and John Abisheganaden.
• Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore.
• J Bronchology Interv Pulmonol. 2016 Apr 1; 23 (2): 123-30.

BackgroundIntensive care unit (ICU) stays are 2.5 times more costly than other hospital stays, and 93.3% of ICU use is for respiratory disease with ventilator support. The aim of this study was to assess the role of bronchoscopy on discontinuation of mechanical ventilation, and prompt discharge from ICU in our institution.MethodsRetrospective review of medical records of patients referred for bronchoscopic intervention for acute respiratory failure from malignant or benign central airway diseases requiring ICU admission.ResultsTwelve critically ill patients were studied. Median (range) age was 63 years (range, 35 to 85 y). Nine (75%) had endotracheal tube, and 3 (25%) had tracheostomy tube. Nine (75%) of 12 patients admitted to ICU could be transferred to general ward after median (range) interval of 2 days (range, 1 to 7 d) after the day of intervention. Median (range) prebronchoscopy and postbronchoscopy PaO2/FiO2 ratio was 102.8 (range, 99.2 to 328) and 180 (range, 129 to 380), respectively, with significant improvement postintervention (P=0.002). Radiologically, all 8 patients with lung atelectasis on presentation experienced complete reexpansion of the lung on the day after bronchoscopic intervention.ConclusionThe majority of patients in our cohort (75%) of benign and malignant etiology could be promptly (within 2 d postbronchoscopy) transferred out from ICU to general ward after successful discontinuation of mechanical ventilation and extubation after bronchoscopic intervention. We advocate early recognition and bronchoscopic intervention in suitable patients.

19 keywords...

hide…