La broncoscopia in unità di terapia intensiva

Bronchoscopy in General and in Respiratory Intensive Care Units is an essential procedure to resolve critical situations that increasingly occur in clinical practice. This exam, especially if applied with flexible device, can perform several diagnostic and therapeutic manoeuvres that can significantly change the patients' outcome. Depending on the issue, there is indication to apply both the flexible and the rigid device which can also be used for various therapeutic purposes. Critical or immunocompromised patients can have particular benefit from the use of endoscopic methods; in these subjects it is extremely important to early obtain microbiological diagnosis of infectious diseases (eg VAP) to apply a proper therapy. Other main indications are: atelectasis, endotracheal intubation assistance, haemoptysis and restore of bronchial patency (which may be compromised by foreign bodies or mucus plugs). The role of bronchoscopy is also important in percutaneous tracheostomy and in the evaluation of eventual contraindications to decannulation. In consideration of the wide possibilities offered by these methods and of their several applications, collaboration between interventional pulmonologists and intensivists assumes primary importance in the management of critical patient.