Fiberoptic bronchoscopy in the intensive care unit: indications, complications, and bronchoscopic culture results

Aims: Fiberoptic bronchoscopy (FOB), although generally considered safe, can lead to significant complications, particularly in critically ill patients. This study aimed to evaluate the indications, complications, and bronchoscopic culture results of FOB in patients monitored in the intensive care unit (ICU). Methods: FOBs performed in the respiratory ICU between December 2021 and July 2024 were evaluated. The indications for FOB, complication rates, and bronchoscopic culture results were analyzed. The relationship between culture growth and inflammatory markers was also assessed. Results: In this study, a total of 454 FOB procedures were performed on 234 patients hospitalized in the ICU. The most common indication for FOB was secretion clearance, accounting for 41.9% of cases. The most frequent procedure-related complications were transient hypoxemia (9%) and minor bleeding (7%). The growth rate in bronchoscopic cultures was determined as 53.2%, while Acinetobacter spp. (11.2%), Pseudomonas spp. (7.3%), and Klebsiella pneumoniae (12.6%) were detected as resistant bacteria. Additionally, a weak but statistically significant correlation was found between CRP levels and bronchoscopic culture growth (p=0.040). Conclusion: FOB is a safely applicable and valuable diagnostic tool in infection management in the ICU. Bronchoscopic cultures can guide targeted antibiotic therapy. However, these findings need to be supported by large-scale studies.