Bronchoscopy in the Intensive Care Unit

Flexible bronchoscopy in the intensive care unit has been recognized as an indispensable tool for intensivists due to its important applications and significant effect on patient care. The indications for bronchoscopy in the intensive care unit (ICU) are numerous, but can be broadly categorized as airway management, diagnostic or therapeutic. While indications vary somewhat between institutions and critical care settings (i.e., surgical, medical), the proportion of diagnostic and therapeutic bronchoscopy performed is generally balanced, with some procedures performed for both diagnostic and therapeutic processes. The safety of flexible bronchoscopy in mechanically ventilated patients has also been specifically assessed. Difficult airways present challenges for intubation in the ICU. Percutaneous dilational tracheostomy (PDT) has become a widespread method of performing tracheostomies in critically ill patients in intensive care units. With the proper equipment and personnel, these procedures can be performed safely and can have a significant impact on the clinical course of critically ill patients.