Factors influencing management modifications following fiberoptic bronchoscopy in critically ill ICU patients
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Issued Date
2024-09-30
Resource Type
ISSN
20721439
eISSN
20776624
Scopus ID
2-s2.0-85205339816
Journal Title
Journal of Thoracic Disease
Volume
16
Issue
9
Start Page
6112
End Page
6122
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Thoracic Disease Vol.16 No.9 (2024) , 6112-6122
Suggested Citation
Maluangnon C., Tongyoo S., Thomrongpairoj P., Disayabutr S. Factors influencing management modifications following fiberoptic bronchoscopy in critically ill ICU patients. Journal of Thoracic Disease Vol.16 No.9 (2024) , 6112-6122. 6122. doi:10.21037/jtd-24-1040 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/101551
Title
Factors influencing management modifications following fiberoptic bronchoscopy in critically ill ICU patients
Author's Affiliation
Corresponding Author(s)
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Abstract
Background: Fiberoptic bronchoscopy (FOB) has evolved into a crucial diagnostic and therapeutic procedure for respiratory tract conditions over the years. Despite its benefits, this approach poses increased risks to critically ill patients. This study aimed to identify clinical parameters that influence management modifications after FOB in the general intensive care unit (ICU) population, an area not extensively explored. Methods: In this retrospective study, critically ill adults admitted to a medical ICU in Bangkok, Thailand, who underwent FOB between January 2013 and December 2022 were enrolled. Clinical parameters, imaging findings, and indications were analyzed to identify factors associated with modifications in post-bronchoscopic management. Results: A total of 118 patients were reviewed and management modifications occurred in 69 patients (58.5%), in which antibiotic modification (78.3%) was the leading reason. Chronic steroid use and suspected interstitial lung disease were associated with management modifications after FOB, while alveolar infiltration on chest radiography was not. Although management modifications showed a trend toward lower mortality, statistical significance was not reached. Multivariate analysis identified chronic steroid use as the only independent factor [adjusted odds ratio (aOR): 2.26; 95% confidence interval (CI): 1.01–5.06; P=0.048]. Conclusions: Among critically ill patients, chronic steroid use was a predictor of management modifications after FOB and is likely to be beneficial.