Bronchoscopy in the diagnosis and therapy of chest injuries

Owing to its technical possibilities, bronchoscopy has also come into frequent use in the treatment of trauma patients, not only for diagnostic but also for therapeutic purposes. It has become a mandatory procedure in the treatment of chest injuries. Following discussion of its history, possibilities and scope, the authors present the results of treatment over the last two years at the University Hospital of Traumatology Zagreb, Croatia. There were 407 bronchoscopies performed in 157 trauma patients (on the average, 2.59 bronchoscopies per patient). According to indications for bronchoscopy, patients were classified into four groups: (a) patients with atelectasis (N = 51), with a total of 68 bronchoscopic procedures (1.33 per patient; (b) patients who developed infiltrates (N = 48) with 162 bronchoscopies (3.37 per patient); (c) patients with excessive secretions (N = 42) with 153 bronchoscopies (3.64 per patient); and (d) patients who developed respiratory insufficiency in the course of treatment (N = 16) with 24 bronchoscopic procedures (1.5 per patient). The best results were achieved in the atelectasis patients--in 74.47% of them there was no need of additional bronchoscopies, whereas in the group with excessive secretions or infiltrates bronchoscopy had to be repeated several times. It may be concluded that today, bronchoscopy is a routine diagnostic and therapeutic method in the treatment of chest injuries.