Diagnosis
In a retrospective study of 115 bronchoscopies in immunocompromised patients, clinical diagnosis was obtained in 51 patients (44%) [PMID:38870553].
Performing transbronchial biopsy correlated with a higher diagnostic yield (54.7% vs 35.5%, P = 0.049) [PMID:38870553].
All nine patients in the study [PMID:25832933] provided diagnostic BAL samples, indicating the procedure's utility in obtaining clinically relevant information under these supportive conditions.
Management
Nine out of 115 cases (7.8%) led to the initiation or modification of immunosuppressive treatment based on negative microbiological results from bronchoscopy [PMID:38870553].
In a retrospective study [PMID:25832933], FOB-BAL performed with an LMA and CPAP in nine patients resulted in a BAL fluid recovery rate of 56% without requiring tracheal intubation post-procedure, maintaining percutaneous arterial oxygen saturation above 90%.
Complications
The study [PMID:25832933] reported no cases of intubation within eight hours post-procedure, despite significant sedation-induced transient hypotension, highlighting reduced hypoxemia risk.
References
1 Nakagawa N, Ando T, Kawakami M, Hosoki K, Hiraishi Y, Mikami Y et al.. Diagnostic yield of flexible bronchoscopy for immunocompromised patients with lung infiltrates: A single-center, retrospective study. Respiratory investigation 2024. link 2 Matsumoto T, Sato Y, Fukuda S, Katayama S, Miyazaki Y, Ozaki M et al.. Safety and efficacy of bronchoalveolar lavage using a laryngeal mask airway in cases of acute hypoxaemic respiratory failure with diffuse lung infiltrates. Internal medicine (Tokyo, Japan) 2015. link
2 papers cited of 6 indexed.