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

Edi Darmawan; Rizki Taufiqurrahman; Sutan Syarif Muda Dalimunthe; Septian Adi Permana; Arie Zainul Fatoni; Teuku Yasir; Andriamuri Primaputra Lubis; Rommy Fransiscus Nadeak; Bastian Lubis

doi:10.71197/jsocmed.v5i5.284

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

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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Published at

31. May 2026
https://doi.org/10.71197/jsocmed.v5i5.284
Issue:

Vol. 5 No. 5 (2026): May
Section:

Case Reports
Keywords:

Bronchoscopy Intensive Care Unit Pneumonia Respiratory Failure Bronchoalveolar Lavage
References:

Bellani G, Laffey JG, Pham T. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 2016;315(8):788-800.

Torres A, Niederman MS, Chastre J. International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia. Eur Respir J. 2017;50(3):1700582.

Kalil AC, Metersky ML, Klompas M. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines. Clin Infect Dis. 2016;63(5):e61-e111.

Kollef MH. Prevention of hospital-associated pneumonia and ventilator-associated pneumonia. Crit Care Med. 2004;32(6):1396-1405.

Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med. 2002;165(7):867-903.

Kreider ME, Lipson DA. Bronchoscopy for atelectasis and mucus plugging in the intensive care unit. Clin Chest Med. 2009;30(1):143-152.

Du Rand IA, Blaikley J, Booton R. British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults. Thorax. 2013;68(1):i1-i44.

Estella A. Bronchoscopy in the intensive care unit. Ann Transl Med. 2018;6(17):344.

Papazian L, Klompas M, Luyt CE. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med. 2020;46(5):888-906.

Cracco C, Fartoukh M, Prodanovic H, et al. Safety of performing fiberoptic bronchoscopy in critically ill hypoxemic patients. Intensive Care Med. 2013;39(1):45-52.

Scala R, Naldi M, Archinucci I. Bronchoscopy in mechanically ventilated patients with respiratory failure. Respiration. 2010;80(5):416-421.

Wahidi MM, Jain P, Jantz M. American College of Chest Physicians consensus statement on bronchoscopy in critically ill patients. Chest. 2011;140(5):1342-1350.

Rouby JJ, Martin De Lassale E, Poete P. Nosocomial bronchopneumonia in the critically ill. Am Rev Respir Dis. 1992;146(5):1059-1066.

de Jager CP, Wever PC, Gemen EF. The neutrophil-lymphocyte count ratio in patients with community-acquired pneumonia. PLoS One. 2012;7(10):e46561.

Liu X, Shen Y, Wang H. Prognostic significance of neutrophil-to-lymphocyte ratio in patients with sepsis. Crit Care. 2016;20(1):1-10.

Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev. 2008;21(3):538-582.

Vincent JL, Rello J, Marshall J. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302(21):2323-2329.

Koenig SM, Truwit JD. Ventilator-associated pneumonia: diagnosis, treatment, and prevention. Clin Microbiol Rev. 2006;19(4):637-657.

Bassetti M, Vena A, Croxatto A. How to manage Pseudomonas aeruginosa infections. Drugs Context. 2018;7:212527.

Ardiayuman A, Budipratama D. Management of sepsis patients due to community-acquired pneumonia in the intensive care unit. Journal of Society Medicine. 2025;4(7):232-237.

Hutasuhut AF, Rismawan B. Management of septic shock secondary to submandibular phlegmon and ventilator-associated pneumonia in the intensive care unit. Journal of Society Medicine. 2025;4(9):284–291.

Saputra WH, Prima A, Wirdah W. Clinical utility of procalcitonin for stratifying severity in sepsis secondary to pneumonia. Journal of Society Medicine. 2026;5(1):31-38.

Nahrisyah P, Syahrani F, Tarigan AP, Ashar T. Survival rate of chronic obstructive pulmonary disease patients with type II respiratory failure at Haji Adam Malik Hospital. Journal of Society Medicine. 2024;3(8):223-230.
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Darmawan, E., Taufiqurrahman, R., Dalimunthe, S. S. M., Permana, S. A., Fatoni, A. Z., Yasir, T., … Lubis, B. (2026). 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. Journal of Society Medicine, 5(5), 188–193. https://doi.org/10.71197/jsocmed.v5i5.284

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Copyright (c) 2026 Edi Darmawan, Rizki Taufiqurrahman, Sutan Syarif Muda Dalimunthe, Septian Adi Permana, Arie Zainul Fatoni, Teuku Yasir, Andriamuri Primaputra Lubis, Rommy Fransiscus Nadeak, Bastian Lubis

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