Risk factors of complications during noninvasive mechanical ventilation -assisted flexible bronchoscopy.
PURPOSE
Flexible bronchoscopy (FB) causes airway narrowing and may cause respiratory failure (RF). Noninvasive mechanical ventilation (NIV) is used to treat RF. Until recently, little was known about noninvasive mechanical ventilation assisted flexible bronchoscopy (NIV-FB) risk and complications.


MATERIALS AND METHODS
A retrospective analysis of NIV-FB performed in 20 consecutive months (July 1, 2018-February 29, 2020) was performed. Indications for: FB and NIV, as well as impact of comorbidities, blood gas results, pulmonary function test results and sedation depth, were analyzed to reveal NIV-FB risk. Out of a total of 713 FBs, NIV-FB was performed in 50 patients with multiple comorbidities, acute or chronic RF, substantial tracheal narrowing, or after previously unsuccessful FB attempt.


RESULTS
In three cases, reversible complications were observed. Additionally, due to the severity of underlining disease, two patients were transferred to the ICU where they passed away after >48h. In a single variable analysis, PaO2 69 ​± ​18.5 and 49 ​± ​9.0 [mmHg] (p ​< ​0.05) and white blood count (WBC) 10.0 ​± ​4.81 and 14.4 ​± ​3.10 (p ​< ​0.05) were found predictive for complications. Left heart disease indicated unfavorable NIV-FB outcome (p ​= ​0.046).


CONCLUSIONS
NIV-FB is safe in severely ill patients, however procedure-related risk should be further defined and verified in prospective studies.
['Skoczyński|Szymon|S|', 'Ogonowski|Maciej|M|', 'Tobiczyk|Ewelina|E|', 'Krzyżak|Damian|D|', 'Brożek|Grzegorz|G|', 'Wierzbicka|Anna|A|', 'Trzaska-Sobczak|Marzena|M|', 'Trejnowska|Ewa|E|', 'Studnicka|Aleksandra|A|', 'Swinarew|Andrzej|A|', 'Kucewicz-Czech|Ewa|E|', 'Gierek|Danuta|D|', 'Rychlik|Wojciech|W|', 'Barczyk|Adam|A|']
Noninvasive mechanical ventilation Flexible bronchoscopy Respiratory failure Airway assessment Complication risk