HARD DECISIONS IN INTENSIVE CARE UNIT

Intensivecareunitkapak

BRONCHOSCOPY IN INTENSIVE CARE

Fatih Seğmen1

Temel Kayan2

1Ankara City Hospital, Department of Intensive Care, Ankara, Türkiye
2Ankara City Hospital, Department of Intensive Care, Ankara, Türkiye

Seğmen F, Kayan T. Bronchoscopy in Intensive Care. In: Turan S, editor. Hard Decisions in Intensive Care Unit. 1sted. Ankara: Türkiye Klinikleri; 2025. p.331-338.

ABSTRACT

Performing bronchoscopy in critically ill patients demands specialized skills and thorough knowledge to ensure safety and successful outcomes. Key aspects include understanding the causes of acute airway insufficiency, emergency airway management principles, and the anatomy of the upper and lower airways for accurate assessment. Clinicians must carefully select patients, identify contraindications, and anticipate complications such as pneumothorax or bleeding. Proper drug use for airway control and adherence to aseptic techniques, including infection prevention measures, are essential. Familiarity with endotracheal tube techniques and the maintenance of flexible fibreoptic bronchoscopes further enhances procedural safety. Beyond technical expertise, preparation and teamwork are critical. Clinicians should consult with senior staff, identify anatomical landmarks, and position the patient appropriately. Informed consent should be obtained when applicable. During the procedure, maintaining an aseptic technique and addressing complications promptly are vital. Postprocedure, thorough cleaning and sterilization of equipment prevent cross-contamination. Respecting patient comfort, privacy, and dignity remains a cornerstone of care. Recognizing personal limitations and seeking guidance when necessary promotes safe practice and fosters a collaborative environment among healthcare providers. This approach ensures effective bronchoscopy in critically ill patients, balancing procedural efficacy with patient-centered care.

Keywords: Bronchoscopy; Acute respiratory failure; Critically ill; Bronchoalveolar lavage; Indication; Complication; Mechanical ventilation

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