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Clinical Investigations in Critical Care: ArticlesTherapeutic Rigid Bronchoscopy Allows Level of Care Changes in Patients With Acute Respiratory Failure From Central Airways Obstruction
Section snippets
Materials and Methods
The medical records of all patients emergently admitted to the ICU of the University of California Medical Center for rigid bronchoscopic intervention between January 1994 and April 1996 were reviewed. All patients had acute onset of respiratory failure from benign or malignant tracheobronchial obstruction, and had been referred to our Pulmonary Special Procedures and Nd-YAG Laser Unit for bronchoscopic management of central airways obstruction. Hospital records and procedure notes were
Results
Between January 1994 and April 1996, a total of 278 individuals were referred to the Pulmonary Special Procedures and Nd-YAG Laser Unit for rigid bronchoscopic intervention. Of this group, 32 critically ill patients (13 male, 19 female) were emergently admitted to the ICU with acute respiratory failure and bronchoscopic evidence of near total or complete central airway obstruction. Thirty patients were directly transferred from other institutions and two were admitted into the ICU from the
Discussion
Concerns for increased health-care expenditures oblige us to repeatedly evaluate the impact of new technologies and procedures on health-care utilization, particularly for patients with life-threatening illnesses. Although the efficacy of therapeutic rigid bronchoscopy, laser resection, and stenting is well recognized for palliation of dyspnea, cough, or hemoptysis, few investigators have attempted to evaluate the impact of these procedures on hospitalization costs or medical management
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revision accepted December 27.