Fiberoptic Bronchoscopy in the Evaluation of Acute Chest and Upper Airway Trauma: Conclusion
In addition, we have compared our two groups who had bronchoscopy performed within three days but had either abnormal or normal findings; however, only generalizations can be made because of the number of variables looked at retrospectively and the risk of claiming an association when none exists. The 53 patients who had bronchoscopy performed within three days of the traumatic event tended to have more of the physical and radiographic findings than the 43 patients who had bronchoscopy performed later; however, none of the reported physical and radiographic findings appeared particularly more common in those who underwent early bronchoscopy to indicate a reason for the procedure. Comparison of our two groups who had early bronchoscopy revealed similar incidences of the physical and radiographic findings, except for the presence of mediastinal emphysema, which was approximately twice as common in the patients with abnormal findings. Of the patients with disruption of the airway, all five patients had mediastinal emphysema, and four of the five had a pneumothorax. http://www.cheap-asthma-inhalers.com/
No specific criteria for performing bronchoscopy in the short-term evaluation of trauma to the chest and upper airway can be made because of the wide spectrum of injuries. This decision must rely on the clinical judgment of the evaluating physician; however, we have shown that bronchoscopy is a useful procedure and should be considered in this setting. In conclusion, we found FFB useful in acute trauma in 28 out of 53 patients in which it was performed within three days of injury. In only one instance was a lesion identified whose full extent was not appreciated. In no other case was there any evidence that any significant abnormalities were overlooked. Because of the rare possibility that lesions could be missed, repeat bronchoscopic procedures should be performed if the clinical situation suggests an abnormality. Examination of the cervical trachea, larynx, and supraglottic region should also be done.