Use of bronchofiberscopy in management of severe thoracic trauma

ObjectiveTo investigate the diagnostic and therapeutic effect of bronchofiberscopy in the management of severe thoracic trauma.MethodsA retrospective study was conducted on 207 consecutive patients with severe thoracic trauma enrolled in our hospital between January 2008 and June 2012. During the period, 488 bronchofiberscopies and lavages were done. The bronchofiberscope was inserted through tracheal incision (282), nasal cavity (149) and oral cavity (57). Intensive SaO₂ monitoring as well as blood gas analysis were performed pre-, intra- and postoperatively. Simultaneously oxygen therapy or ventilatory support was given. Sputum culture was done intraoperatively.ResultsDiagnosis in 207 cases was confirmed by bronchofiberscopy. The result of sputum culture was positive in 78 cases. Lavage was performed on 156 cases. SaO₂ significantly increased after bronchofiberscopies as well as lavages and PaO₂ obviously improved 2 h after surgery (both P<0.05). Heart rate and respiratory rate decreased. There was no bronchofiberscopy-related death.ConclusionBronchofiberscopy plays an important role in the diagnosis and treatment of severe thoracic trauma, which can not only timely diagnose bronchial injury and collect deep tracheal sputum for bacterial culture but also effectively remove foreign body, secretion, blood and sputum crust in the airway, manage obstructive atelectasis and pneumonia, and significantly improve respiratory function and treatment outcome.