Deotare U, et al. - Researchers, herein, focused on the utility and safety of performing flexible bronchoscopy with bronchoalveolar lavage (BAL) in critically ill acute leukemia (AL) patients. They found that in this patient population, flexible bronchoscopy with BAL was relatively safe and helped to guide medical management.

Methods

• A total of 71 AL patients who underwent diagnostic bronchoscopy with BAL in the intensive care unit (ICU) between 1 January 2007 and 31 December 2012 were assessed.
• Baseline characteristics, vital signs (before, during, and after the procedure), changes in medical management following the procedure, and procedural complications were recorded.
• Researchers used a multivariable logistic regression model to explore the link between patient characteristics and if bronchoscopy changed management or caused complications.
• Age, sex, immunosuppression status (those undergoing active chemotherapy), and the Acute Physiology And Chronic Health Evaluation II score were the patient characteristics included as predictors in the regression model.

Results

• Respiratory failure (51 patients, 72%), followed by sepsis (14 patients, 20%), was identified as the most common indication for ICU admission.
• Findings demonstrated that the results obtained from bronchoscopy with BAL were related to a change in management in 32 patients (45%), most commonly a change in antimicrobial therapy as a result of an infectious pathogen being identified (17 patients, 24%).
• Researchers found that 9 patients (13%) developed complications, which included post-procedural hypoxia (six patients, 8%), the need for intubation (one patient, 9% of non-intubated patients), and tracheal perforation (one patient, 1%).
• Data also reported that during or immediately following the procedure, no clinically significant changes in patient vital signs were observed.
• In addition, it was shown that patient characteristics did not predict if bronchoscopy was related to changes in medical management or procedural complications in multivariable analyses.