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Safety of research bronchoscopy in critically ill patients
- Source :
- Journal of Critical Care. 29:961-964
- Publication Year :
- 2014
- Publisher :
- Elsevier BV, 2014.
-
Abstract
- Objective Bronchoscopy and bronchoalveolar lavage (BAL) are common procedures in intensive care units; however, no contemporaneous safety and outcomes data have been reported, particularly for critically ill patients. Design This is a retrospective analysis of prospectively collected data from teaching hospital adult intensive care units. Interventions One hundred mechanically ventilated patients with severe sepsis, septic shock, acute lung injury (ALI), and/or acute respiratory distress syndrome underwent bronchoscopy with unilateral BAL. Data collected included demographics, presence of sepsis or ALI, Pa o 2 to F io 2 ratio, positive end-expiratory pressure, Acute Physiology and Chronic Health Evaluation score, Sequential Organ Failure Assessment score, and peri- or postprocedural complications. Results Men comprised 51% of the patients; 81% of the patients were black, and 15% were white. The mean age was 52 (SD, ± 16) years. The mean Acute Physiology and Chronic Health Evaluation score was 22 (± 7.5), whereas the median Sequential Organ Failure Assessment score was 9 (interquartile range, 5-12). Ten patients (10%) had complications during or immediately after the procedure. Hypoxemia during or immediately after the BAL was the most common complication. Ninety percent of the complications were related to transient hypoxemia, whereas bradycardia and hypotension each occurred in 1 patient. Age, female sex, and higher positive end-expiratory pressure were associated with complications. Conclusions Bronchoscopy with BAL in critically ill patients with sepsis and ALI is well tolerated with low risk of complications, primarily related to manageable hypoxemia.
- Subjects :
- Adult
Male
medicine.medical_specialty
Organ Dysfunction Scores
Critical Illness
Acute Lung Injury
Lung injury
Critical Care and Intensive Care Medicine
Bronchoalveolar Lavage
Article
Hypoxemia
Positive-Pressure Respiration
Sepsis
Sex Factors
Bronchoscopy
Interquartile range
Intensive care
medicine
Humans
Hypoxia
APACHE
Aged
Retrospective Studies
Respiratory Distress Syndrome
medicine.diagnostic_test
Septic shock
business.industry
Middle Aged
medicine.disease
Shock, Septic
respiratory tract diseases
Surgery
Intensive Care Units
Anesthesia
Female
Hypotension
Safety
medicine.symptom
Complication
business
Subjects
Details
- ISSN :
- 08839441
- Volume :
- 29
- Database :
- OpenAIRE
- Journal :
- Journal of Critical Care
- Accession number :
- edsair.doi.dedup.....4326eea12ba04ba7206b7b063e32de56