CRITICAL CARE - ADULTS / REVIEW ARTICLE
Flexible bronchoscopy in mechanically ventilated critically ill patients: practical considerations and clinical applications – a narrative review
1
Klara Jelska’s Pulmonary Hospital, Zakopane, Poland
2
Mountain Medicine Laboratory, Jagiellonian University Medical College, Zakopane, Poland
3
Tytus Chalubinski’s General Hospital, Zakopane, Poland
4
St. John Paul II Hospital, II Intensive Care Unit, Krakow, Poland
5
Department of Anesthesiology and Intensive Therapy, Jagiellonian University Medical College, Krakow, Poland
6
Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland
7
St. John Paul II Hospital, Endoscopy Unit, Krakow, Poland
Submission date: 2025-09-24
Final revision date: 2026-01-21
Acceptance date: 2026-02-19
Publication date: 2026-03-18
Corresponding author
Anaesthesiol Intensive Ther 2026;58(1):49-58
KEYWORDS
TOPICS
ABSTRACT
Flexible bronchoscopy (FB) is an established diagnostic and therapeutic tool for critically ill patients. Technological advances have enabled rapid and convenient bedside availability in the intensive care unit, expanding the range of therapeutic indications for the procedure outside the endoscopy laboratory. FB in critically ill patients, especially mechanically ventilated patients, is technically challenging and requires appropriate operator qualifications. To avoid serious complications, it is essential to understand the procedure’s effects on the respiratory and circulatory systems, as well as the mechanisms of complications, including infection transmission. A key challenge is to individually determine the expected benefit-risk balance and implement local protocols for the preparation, implementation, and supervision of the procedure. This narrative review aims to explore the practical and clinical aspects of FB in critically ill, mechanically ventilated patients in the ICU environment, emphasizing the most common interventions and safety issues.
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