| Title |
The utility and safety of flexible bronchoscopy in critically ill acute leukemia patients: a retrospective cohort study
|
|---|---|
| Published in |
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, December 2017
|
| DOI | 10.1007/s12630-017-1041-7 |
| Pubmed ID | |
| Authors |
Uday Deotare, Erica Merman, Daniel Pincus, Alan P. Kraguljac, Danielle Croucher, Vikram Kumar, Narmin Ibrahimova, Mark D. Minden, Christie Lee, Sangeeta Mehta |
| Abstract |
Flexible bronchoscopy with bronchoalveolar lavage (BAL) is commonly performed in immunocompromised patients. Nevertheless, it remains unclear whether bronchoscopy with BAL leads to changes in medical management or is associated with procedural complications among critically ill acute leukemia (AL) patients. We evaluated 71 AL patients who underwent diagnostic bronchoscopy with BAL in the intensive care unit (ICU) between 1 January 2007 and 31 December 2012. We recorded baseline characteristics, vital signs (before, during, and after the procedure), changes in medical management following the procedure, and procedural complications. Using a multivariable logistic regression model, we explored the relationship between patient characteristics and whether bronchoscopy changed management or caused complications. Patient characteristics included as predictors in the regression model were age, sex, immunosuppression status (those undergoing active chemotherapy), and the Acute Physiology And Chronic Health Evaluation II score. The most common indication for ICU admission was respiratory failure (51 patients, 72%), followed by sepsis (14 patients, 20%). Overall, the results obtained from bronchoscopy with BAL were associated with 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%). Complications were documented in nine patients (13%) and included post-procedural hypoxia (six patients, 8%), the need for intubation (one patient, 9% of non-intubated patients), and tracheal perforation (one patient, 1%). No clinically significant changes in patient vital signs were observed during or immediately following the procedure. Patient characteristics did not predict whether bronchoscopy was associated with changes in medical management or procedural complications in multivariable analyses. Flexible bronchoscopy with BAL is relatively safe and helps to guide medical management among patients with AL admitted to the ICU. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 2 | 67% |
| Unknown | 1 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 33% |
| Science communicators (journalists, bloggers, editors) | 1 | 33% |
| Members of the public | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 21 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 21 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 5 | 24% |
| Student > Master | 3 | 14% |
| Student > Bachelor | 2 | 10% |
| Librarian | 1 | 5% |
| Unspecified | 1 | 5% |
| Other | 3 | 14% |
| Unknown | 6 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 29% |
| Nursing and Health Professions | 3 | 14% |
| Engineering | 2 | 10% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 5% |
| Unspecified | 1 | 5% |
| Other | 2 | 10% |
| Unknown | 6 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 March 2018.
All research outputs
#15,989,045
of 25,382,440 outputs
Outputs from Canadian Journal of Anesthesia/Journal canadien d'anesthésie
#2,172
of 2,878 outputs
Outputs of similar age
#250,926
of 446,012 outputs
Outputs of similar age from Canadian Journal of Anesthesia/Journal canadien d'anesthésie
#52
of 55 outputs
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