Fiberoptic bronchoscopy in the intensive care unit

The primary uses of FFB in the intensive care unit are in the diagnosis of opportunistic infection and for airway management. In addition, use of PTC brush or BAL with quantitative cultures may allow identification of the specific cause of bacterial pneumonia. Determination of the location and cause of pulmonary hemorrhage is possible in the intubated patient without massive hemoptysis. Use of FFB in atelectasis is more controversial and less commonly encountered. Other uses include foreign body retrieval, tamponade of bleeding segments and diagnosis/treatment of BPF. In addition to development of technical skills and knowledge of the indications for FBB, critical care physicians should be aware of contraindications and potential complications, as well as steps to minimize the latter.