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Evaluation of a 24-hour emergency bronchoscopy service in a tertiary care hospitalDepartment of Respiratory Medicine, Medizinische Hochschule Hannover, Hannover, Germany, fuehner.thomas{at}mh-hannover.de
Department of Cardiology and Respiratory Medicine, Klinikum Minden, Minden, Germany
Department of Internal Medicine, Krankenhaus Bad Oeynhausen, Bad Oeynhausen, Germany
Institute for Medical Microbiology and Hospital Epidemiology, Medizinische Hochschule Hannover, Hannover, Germany
Department of Respiratory Medicine, Medizinische Hochschule Hannover, Hannover, Germany
Department of Respiratory Medicine, Medizinische Hochschule Hannover, Hannover, Germany Background: Flexible bronchoscopy has become an important diagnostic and therapeutic tool for the management of patients with various diseases of the chest. Availability of a 24-hour bronchoscopy service equipped with experienced personnel is becoming increasingly important especially for intensive care patients. However, such services have been implemented only in a few medical centres. The aim of this study was to evaluate the usage of a 24-hour emergency service in a large university hospital with a 1 year prospective analysis of emergency bronchoscopy service in a tertiary care centre. Methods: Frequencies, indications and efficiency of therapeutic interventions were evaluated after each bronchoscopy using a specially designed questionnaire. All bronchoscopies were performed as emergency procedures out of operational schedule. A total of 614 emergency bronchoscopies were performed, 88% of them in intensive care units. Results: The vast majority (84.5%) of the procedures were necessary for therapeutic interventions; that is, atelectasis, airway secretion, aspiration or bronchopulmonary bleeding. According to prespecified criteria, 37.6% (n = 195) of therapeutic procedures were assessed as 'very helpful' and 3.9% (n = 20) as 'life saving'. Diagnostic bronchoscopies were performed mainly to collect airway material for microbiological evaluations in immunocompromised patients. In these cases, the diagnostic yield was approximately 50%. Conclusion: The availability of a 24-hour bronchoscopy service has been found to improve patient care and was occasionally considered life saving. Thus, comparable services should be made more widely available.
Key Words: bronchoscopy service • emergency bronchoscopy • flexible fiberoptic bronchoscopy • 24-hour service • prospective analysis
This version was published on April
1, 2009 Therapeutic Advances in Respiratory Disease, Vol. 3, No. 2,
65-71 (2009) |
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