Diagnostic bronchoscopic examination in the department of medicine, Chulalongkorn Hospital (experience with 885 cases).
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Transbronchial lung biopsy (TBB) was performed during fiberoptic bronchoscopy under fluoroscopic guidance in 133 patients with diffuse or peripherally localized lung diseases without endobronchial lesions. Histological diagnosis consistent with the clinical course and roentgenographic appearance was obtained in 96 patients (72%). In four cases specimens were inadequate for histological evaluation (3%). In 33 cases a diagnosis was not possible even though the specimens were adequate for histological examination. The low complication rate in this series seems due to the selection of patients and the technique used.
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Fiberoptic bronchoscopy is a valuable tool in the intensive care unit. The procedure may be an integral part of airway management and has diagnostic and treatment capabilities. Demonstrated expertise is necessary to perform the procedure safely and effectively. This expertise may be particularly important when faced with a complex patient who presents with airway management problems or significant hemoptysis.
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