Bronchoscopy in the ICU
A bronchoscopy (bronch) can be done to see the airways and obtain samples of mucus or tissue from within the lungs. The doctor places a thin tube or “scope” through the patient’s nose, mouth, or through a pre-existing breathing tube and into the lungs. The scope displays pictures on a video screen at the bedside. Before this is done, patients are given drugs for pain and to make them sleepy.
There are common reasons for having a bronchoscopy. They include:
- Increased secretions and decreased oxygen levels – Extra fluid, mucus or aspirated material in the lungs makes it hard for the body to absorb oxygen. This leads to lower levels in the body. During a bronch this material can be removed. This may help the body to return to more normal levels.
- Lung collapse – When lungs collapse over and over, there is often something blocking the airway. A bronch can locate the blockage within the lung and remove it. This blockage could be mucus or a foreign object such as a peanut.
- Bleeding – A scope can be used to find out the cause of the bleeding. For instance, a tumor may be causing the bleeding. In this case, a piece of the tumor can be sent to the lab for further study.
- A lung spot – If the doctor suspects a tumor, he or she may use the scope to biopsy the lung spot.
- Infections – Certain infections are best picked up by using bronchoscopy. Samples from particular areas of the lung are sent to the lab to try to find out the exact cause of the infection. This is common for patients on ventilators and those with weakened immune systems.
As with any procedure, there are risks. Some of the risks include:
- Pain and coughing – As the scope is inserted, it is normal to cough and feel pain. Most often, patients are given drugs to relieve the pain, reduce the coughing, and make them feel relaxed and sleepy.
- Lung leak or collapse – Patients needing a bronch often have lungs that are already inflamed or diseased. Therefore, there is a greater risk of causing a lung leak. That leak can lead to lung collapse. Lung leak or collapse is not common, but is more likely when a biopsy is done. If a leak were to occur, the doctor would likely place a chest tube through the chest wall to relieve the air.
- Decreased oxygen – Oxygen levels may decrease during a bronchoscopy. The scope can block air flow. Also, fluid used to “wash” out the lung can briefly drop levels. Nurses and doctors watch these levels closely and give extra oxygen, as needed.
- Bleeding – Bleeding can occur even when a biopsy is done the correct way or if a tumor is nicked. If this happens, the bleeding is often minor and stops on its own. Rarely, bleeding can lead to severe breathing problems requiring surgery.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 11/06/2012
Copyright © 11/06/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6342
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