The Role of Bronchoscopy as a Diagnostic and Therapeutic Modality in Critically Ill Patients with Respiratory Failure and Pneumonia in the Intensive Care Unit: A Descriptive Observational Study

Authors

  • Edi Darmawan
    Department of Anesthesiology and Intensive Care, dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia
  • Rizki Taufiqurrahman
    Department of Anesthesiology and Intensive Care, dr. H. Yuliddin Away General Hospital, South Aceh, Indonesia
  • Sutan Syarif Muda Dalimunthe
    Department of Anesthesiology and Intensive Care, H. OK Arya Zulkarnaen Regional General Hospital, Batubara, Indonesia
  • Septian Adi Permana
    Department of Anesthesiology and Intensive Care, dr. Moewardi General Hospital, Surakarta, Indonesia
  • Arie Zainul Fatoni
    Department of Anesthesiology and Intensive Care, dr. Saiful Anwar General Hospital, Malang, Indonesia
  • Teuku Yasir
    Department of Anesthesiology and Intensive Care, dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia
  • Andriamuri Primaputra Lubis
    Department of Anesthesiology and Intensive Care, H. Adam Malik General Hospital, Medan, Indonesia
  • Rommy Fransiscus Nadeak
    Department of Anesthesiology and Intensive Care, H. Adam Malik General Hospital, Medan, Indonesia
  • Bastian Lubis
    Department of Anesthesiology & Intensive Care, Faculty of Medicine, Universitas Sumatera Utara

Abstract

Introduction: Respiratory failure remains a major cause of intensive care unit (ICU) admission and is associated with substantial morbidity and mortality worldwide. Pneumonia frequently results in respiratory failure requiring invasive mechanical ventilation. Bronchoscopy enables direct airway visualization and bronchoalveolar lavage (BAL), providing important diagnostic and therapeutic benefits in critically ill patients. This study evaluated the role of bronchoscopy in ICU patients with pneumonia-associated respiratory failure.


Methods: This descriptive observational study was conducted in the adult ICU of RSUP H. Adam Malik Medan, Indonesia. Adult patients with pneumonia-associated respiratory failure requiring invasive mechanical ventilation who underwent bronchoscopy during ICU treatment in December 2025 were included. Data were obtained from medical records, bronchoscopy reports, laboratory investigations, and radiological examinations. Outcomes included chest radiographic findings, leukocyte count, neutrophil-to-lymphocyte ratio (NLR), and BAL culture results.


Results: Eighteen patients were included. Radiological improvement was observed in 13 patients (72%), whereas deterioration was observed in five (28 %) patients. Improvement in leukocyte count occurred in 16 (89%) patients, and improvement in NLR was identified in 15 (83%) patients. BAL cultures predominantly revealed Acinetobacter baumannii, followed by Klebsiella pneumoniae and Pseudomonas aeruginosa.


Conclusion: Bronchoscopy provides important diagnostic and therapeutic benefits in ICU patients with pneumonia-associated respiratory failure by facilitating airway clearance, improving inflammatory parameters, and supporting targeted antimicrobial therapies.

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