TY - T1的急性呼吸衰竭的诊断和结果在免疫功能低下的患者支气管镜检查JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.02442 -2018欧元六世- 54 - 1 SP - 1802442 AU -鲍尔,菲利普·r . AU - Chevret西尔维盟——Yadav, Hemang AU -梅塔,彼得•AU - Bukan桑吉塔•AU - Pickkers白木b . AU - Rello,乔迪AU - van de Louw安德利盟——Klouche Kada盟——Meert Anne-Pascale盟——Martin-Loeches Ignacio AU -沼泽,布莱恩AU -副部Crespi,洛伦佐盟——Moreno-Gonzalez Gabriel AU - Buchtele尼娜AU -,卡琳盟——Balik马丁AU -安东内利,马西莫盟——Nyunga马蒂娜盟——Barratt-Due Andreas AU -伯格曼,丹尼斯C.J.J. AU - Spoelstra-de人,安吉丽卷非盟- Kuitunen安妮盟,钱包,弗洛伦特·AU -·赛甘·,天使爱美丽AU -迈塔克瑟白兰地,维多利亚AU - Lemiale,小薇吉妮AU - Burghi,加斯顿盟——Demoule Alexandre盟——Karvunidis托马斯AU - Cotoia,安东内拉·欧·拉斯泰利——Klepstad Pal盟——MøllerAnn m . AU - Mokart Djamel AU -·阿祖莱埃利A2 - Y1 - 2019/07/01 UR - //www.qdcxjkg.com/content/54/1/1802442.abstract N2 -目的我们希望探索使用,诊断能力和支气管镜检查的结果添加到无创检测免疫功能不全的患者。在这种情况下，无法确定急性低氧性呼吸衰竭的原因与更糟糕的结果相关。应尽一切努力获得诊断，或单独进行无创检测，或结合支气管镜检查。然而，我们对支气管镜检查的风险和益处的认识仍然不确定。患者与方法这是对Efraim的一项预先计划的二次分析，这是一项前瞻性的、多国的、观察性的研究，研究对象是1611名住进重症监护病房(ICU)的免疫功能不全的急性呼吸衰竭患者。我们通过双变量分析和倾向评分匹配将接受无创检查的患者与接受支气管镜检查的患者进行了比较。结果618例(39%)患者行支气管镜检查，这些患者更容易发生血液恶性肿瘤，病情严重程度评分较高。仅支气管镜检查就有165名患者确诊(27%的诊断率调整)。经支气管镜检查，236名患者的治疗方法发生了改变(38%的治疗率)。 Bronchoscopy was associated with worsening of respiratory status in 69 (11%) patients. Bronchoscopy was associated with higher ICU (40% versus 28%; p<0.0001) and hospital mortality (49% versus 41%; p=0.003). The overall rate of undiagnosed causes was 13%. After propensity score matching, bronchoscopy remained associated with increased risk of hospital mortality (OR 1.41, 95% CI 1.08–1.81).Conclusions Bronchoscopy was associated with improved diagnosis and changes in management, but also increased hospital mortality. Balancing risk and benefit in individualised cases should be investigated further.In a pre-planned analysis of immunocompromised critically ill patients with acute respiratory failure, bronchoscopy was associated with better diagnosis and management but worse outcome. The decision to perform bronchoscopy should be individualised. http://bit.ly/2Dusahh ER -