The technique of fiberoptic bronchoscopy. Diagnostic and therapeutic uses in intubated, ventilated patients

Abstract

Fiberoptic bronchoscopy has a variety of applications in the intensive care unit. This procedure, which can be done at the patient's bedside, can be used to clear excess secretions; check the position of, or replace, an endotracheal tube; identify areas of active bleeding; diagnose opportunistic infections; and evaluate obstructive airway lesions. Before the bronchoscope is inserted, antisialagogues, anxiolytics, and topical anesthetics are administered along with supplemental oxygen. In intubated, ventilated patients, a fiberoptic bronchoscope may be passed through a swivel adapter to prevent loss of the delivered oxygen and tidal volume. Cardiac arrhythmias and hypoxemia are among the most common complications.