Acute hypoxaemic respiratory failure in immunocompromised patients: abandon bronchoscopy or make it better?. Issue 6 (12th December 2019)

• Record Type: Journal Article
• Authors: Zinter, Matt S.; Cheng, Guang-Shing
• Is Part Of: European respiratory journal. Volume 54:Issue 6(2019)
• Publication Date: 2019-12-12
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.01950-2019
• Languages: English
• ISSNs: 0903-1936

Abstract

Acute hypoxemic respiratory failure (AHRF) in immunocompromised patients is a challenging clinical problem associated with mortality rates of 40–60% in children and adults [1, 2]. Thus, we read with great interest the results of a pre-planned secondary analysis of a large multicentre observational cohort of 1611 immunocompromised adults with AHRF, as reported by Bauer et al. [3]. The authors described the diagnostic yield and outcomes of fibreoptic bronchoscopy (FOB) in this group of vulnerable patients with the a priori hypothesis that "bronchoscopy, with limited complications, would reduce the number of unidentified causes of respiratory failure and be associated with reduced hospital mortality." After a rigorous analysis of a highly annotated dataset, the authors conclude that "bronchoscopy was associated with improved diagnosis and changes in management but also increased hospital mortality." A discussion of the strengths and limitations of recent data associating bronchoscopy with mortality in immunocompromised adults with acute hypoxaemic respiratory failure http://bit.ly/31mMpGL