Introduction: Flexible bronchoscopy (FB) is a procedure usually carried out in the hospital setting. Occasionally, home hospitalized (HH) patients or those at long-term acute care facilities (LTACF) are not likely to be transferred to hospitals, either because they refuse to be transferred or because such transfer may be risky or complex. Under such circumstances, FB could be performed in both sites, especially in technically simple procedures or with a low complication rate.
Objectives: The purpose of this study was to assess whether FB carried out at LTACF or in the home is safe, useful, well tolerated, and free of complications.
Patients and methods: This study analyzed FB carried out at LTACF or in HH patients from October 2007 to November 2009. The procedures chosen were structural and functional assessment of the airway (SFAA) owing to potential tracheal stenosis, tracheomalacia, tracheo-esophageal fistula, phonation or swallowing disorders, and as earlier control to decannulation. Other techniques used were: aspiration of tracheobronchial mucus (ATBM), complex tracheostomy tube changes (TTC), tracheal prosthesis control (TPC), evaluation of mild hemoptysis (MH), and bronchoalveolar lavage (BAL). FB was carried out under local anesthesia. The endoscope entered through the nose, mouth, tracheostomy tube, and/or T-tracheal prosthesis.
Results: Thirty-three FB were carried out in 25 LTACF patients: 33 SFAA, 3 MH, 3 TTC, 2 ATBM, 1 BAL, and 2 TPC. Ten FB were carried out in 8 HH patients: 10 SFAA, 4 TTC, and 7 ATBM. Procedures were well-tolerated. There was no evidence of complications.
Conclusions: FB carried out outside the hospital setting can be done safely and effectively, at least in a selected group of patients and carrying out selected procedures.