Fibrobroncoscopia en una unidad de vigilancia intensiva respiratoria

objective: to describe the indications, diagnostic performance and safety of fiberoptic bronchoscopy (fob) performed in a respiratory intensive care unit (ricu). design: a prospective, observational study was carried out. setting: a 6-bed ricu in a tertiary university hospital. patients: patients admitted to ricu who required fob. interventions: none. main measurements: fob indications and complications, endoscopic procedures, time required to perform fob. results: sixty-nine out (23%) of the 297 patients admitted to the ricu underwent a total of 107 fob. sixty-eight percent of fob were performed in patients on mechanical ventilation. fob was performed for diagnostic and therapeutic purposes in 88 (82%) and 19 cases (18%), respectively. the study of pulmonary infiltrates was the main indication for diagnostic fob (44 cases; 50%), particularly in immunocompromised patients (24 cases; 27%). in immunocompromised patients the diagnostic performance of fob was significantly higher than in immunocompetent subjects (48% vs 30%; p<0.01). no major complications were recorded. only a significant drop in pao2/fio2 ratio was observed (182±74 vs 163±79; p<0.005) in patients undergoing bronchoalveolar lavage. overall mortality in patients in the ricu was 14%. in patients requiring a single fob procedure, mortality was 25%, versus 45% among those requiring more than one fob procedure. conclusions: these results show that fob is used commonly in the ricu. it is a safe and fast procedure that contributes significantly to clinical management. patients requiring additional fob during admission to the ricu show high mortality.