Safety of Rigid Bronchoscopy for Therapeutic Intervention at the Intensive Care Unit Bedside

Area of Science:

• Pulmonology
• Critical Care Medicine
• Interventional Pulmonology

Background:

• Rigid bronchoscopy is typically performed in the operating room (OR) under general anesthesia.
• Emergent situations may necessitate rigid bronchoscopy at the intensive care unit (ICU) bedside.

Purpose of the Study:

• To evaluate the safety and complication rates of rigid bronchoscopy performed at the ICU bedside compared to the OR.

Main Methods:

• Retrospective analysis of 336 patients undergoing rigid bronchoscopy between January 2014 and December 2020.
• Patients were divided into an ICU bedside group (n=171) and an OR group (n=165).
• Multivariable logistic regression was used to analyze complication risks in the ICU group versus the OR group.

Main Results:

• No significant difference in intra-procedural complications between ICU and OR groups (86.0% vs. 80.6%).
• Post-procedural complications were more frequent in the ICU group (24.0% vs. 12.1%, p=0.005).
• Severe post-procedural complications were also more common in the ICU group (10.5% vs. 4.8%, p=0.052), though not statistically significant in adjusted analysis.

Conclusions:

• Rigid bronchoscopy can be safely performed at the ICU bedside for selected emergency cases.
• Close post-procedural monitoring and careful patient selection are essential to mitigate risks.
• While not statistically significant, increased severe post-procedural complications in the ICU group warrant attention.