Review article

Bronchoscopy in Diagnosing Respiratory Infections

Ivan Gudelj
Vide Popović
Dino Ilak

Abstract

Bronchoscopy is one of the main diagnostic procedures in respiratory diseases. Nowadays we use bronchoscopy more and more in diagnosing respiratory infections. In infective respiratory diseases we use bronchoscopy mostly for determining infectious agents in immunocompromised patients, mechanically ventilated patients, and in patients with community-acquired pneumonia with initial therapeutic failure. A limitation of bronchoscopy findings is a risk of material contamination during the procedure. For that reason more sophisticated techniques have been developed to minimise the risk of contamination. The most commonly used techniques are bronchial washing (minilavat), protected specimen brush, transbronchial biopsy and transbronchial (or transtracheal) needle aspiration. Infected area minilavat and the protected specimen brush are the most suitable for bacteriological sampling (the lowest possibility of contamination); transbronchial biopsy is best for the diagnosis of specific pathogens, such as intracellular patogens and fungi. Possible complications of bronchoscopy are hypoxemia, bleeding (in transbronchial biopsy and bronchial brushing), pneumothorax (transbronchial biopsy and less often in bronchial brushing), and the spread of the infection. In addition, during bronchoscopy arrhythmia or hypotension can occur in mechanically ventilated patients (because of the additionally increased positive expiratory pressure). Nevertheless, a careful selection of patients and the most appropriate sampling technique, together with bronchoscopist’s technical skills, contribute greatly to accurate diagnosis and to the treatment of severe pneumonia.

Keywords

bronchoscopy; respiratory infection; indications; techniques; complications

Hrčak ID:

161762

URI

https://hrcak.srce.hr/161762

Publication date:

13.7.2016.

Article data in other languages: croatian

Visits: 3.460 *