ELECTROMAGNETIC NAVIGATED BRONCHOSCOPY COMBINED WITH RAPID CYTOLOGICAL ASSESSMENT CLARIFIED THE ETIOLOGICAL PROPERTIES AND GUIDED THE TREATMENT OF 7 PATIENTS WITH SEVERE PNEUMONIA IN ICU

Lijia Zhi^{1, #}, Xiangwen Weng^{1, #}, Peiyang Gao¹, Yanming Hao¹, Kunlan Long¹, Meixin Xu¹, Xing An², Qiang Qu^{3, *}

¹Department of Critical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China - ²Respiratory department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China - ³Anesthesiology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China

Background: For ICU patients with severe pneumonia, aetiology examinations are still a challenge. Electromagnetic Navigation Bronchoscopy (ENB), fast cytological evaluation, and rapid onsite evaluation (ROSE) are widely applied on biopsies of the surrounding lung nodules lesions. Breath in critically ill patients with pneumonia is unclear, the application of value through reports by the above methods clarify the aetiology of 7 patients with severe pneumonia. This study explores the value of ENB combined with ROSE in the etiological examination of patients with severe pneumonia.

Case sharing: Between December 2018 and April 2019, in Chengdu University of Traditional Chinese Medicine Hospital’s ICU, 7 cases of CT showed diffuse change; routine clinical aetiology cultures were positive, but the inefficiency of routine anti-infection treatment of patients with severe pneumonia, the navigation channel, by extending the work after the biopsy specimen line fast cytological evaluation and subsequent pathological histology detection, aetiology suggests: There were 2 cases of viral pneumonia, 1 case of pulmonary metastatic malignant tumour combined with fungal pneumonia, 1 case of organized pneumonia, 1 case of pulmonary fibrous tissue hyperplasia, and 2 cases of lung biopsy showing no obvious abnormalities. The medication was adjusted according to the results of the etiological examination, the last 5 cases were improved, and 2 cases died due to aggravation of the disease.

Conclusion: ENB combined with ROSE helped determine critical SARS patients’ lesions tissue pathological and histological results of cytology, groups, and to narrow the differential diagnosis, clear disease aetiology, and understand that disease states to guide the clinical treatment, and security is good, is to promote the development of diagnostic involved in breathing epidemiology in ICU an emerging technology, and is worth popularizing in clinic.