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From the operating room to critical care: Why bronchoscopy is essential in critical moments?
Bronchoscopy is an endoscopic technique used primarily to examine the interior of the airways, either for diagnostic or therapeutic purposes. A professional can insert an instrument called a bronchoscope through the nose or mouth or, in rare cases, through a tracheotomy. This allows doctors to check for abnormalities in the patient's airway, such as foreign objects, bleeding, tumors or inflammation. Doctors may also take samples from the lungs for further examination. Bronchoscopes come in a variety of designs, ranging from rigid metal tubes with lights to flexible fiber-optic instruments with real-time video equipment.
Bronchoscopy originated in 1897 when German otolaryngologist Gustav Kilian performed the first bronchoscopy to remove a pig bone.
As technology advances, the types of bronchoscopes are evolving. There are two main types of bronchoscopes: rigid bronchoscopes and flexible bronchoscopes. A rigid bronchoscope is a hollow metal tube used primarily to examine the lower respiratory tract, often for therapeutic purposes. Flexible bronchoscopes are longer and slimmer and have the ability to transmit images to an observation end or video camera, making them flexible enough to respond to different situations.
Flexible bronchoscopes cause less discomfort to patients during the examination and can usually be performed safely under moderate sedation. They have become the preferred technology for current bronchial examinations.
Bronchoscopy in critical situations
Bronchoscopy plays a vital role in critical care. Especially in the intensive care unit, flexible bronchoscopes can be used to treat patients with endotracheal intubation or tracheotomy, providing diagnostic and therapeutic assistance. In diagnostic use, bronchoscopy can be used to obtain targeted deep breath samples to help rule out or confirm pneumonia or other lung pathology.
Bronchoscopy is an indispensable step in the management of critically ill patients, as it allows direct visualization of lesions within the airways.
Procedure and recovery process
A bronchoscopy is usually done in a specialised ward, operating theatre or intensive care unit. Your doctor may give you medication to relieve anxiety and a local anesthetic to numb your throat and airway. During the examination, the patient's blood pressure, electrocardiogram and blood oxygen level will be continuously monitored. Once the bronchoscope is inserted, the doctor will examine the entire airway and may collect samples at any time if there are any abnormalities.
After the examination, although most patients tolerate the procedure well, they will need to be observed briefly to ensure that no complications occur. Certain complications, such as pulmonary hemorrhage or pneumothorax, may require hospitalization.
Risks and Complications
Although bronchoscopy is generally considered a low-risk procedure, the risk of complications increases substantially in the intensive care unit. Common complications include excessive bleeding, pneumothorax, and breathing difficulties. Therefore, it is very important to receive good training and careful technical operation when using bronchoscope.
The risks of bronchoscopy are significantly lower than the diagnostic and therapeutic benefits it brings, which makes bronchoscopy play an indispensable role in the medical community.
In critical situations, the use of bronchoscopes not only provides patients with timely diagnosis and treatment options, but also provides a platform for medical teams to overcome challenges. In daily medical operations, should people pay more attention to the advancement and application of this technology?
