Indications and Contraindications in Flexible Bronchoscopy

This chapter seeks to review the indications and contraindications for use of the flexible bronchoscope from a practical viewpoint and as first determined by the symptoms, signs, and imaging studies for which the patient will first present to the bronchoscopist. Although the frequency with which bronchoscopy is performed for cough and its low yield indicate that this is an overutilized procedure, a directed pulmonary evaluation in the context of the individual patient's presentation is recommend. The evaluation of wheezing in the nonasthmatic patient or patient poorly responsive to bronchodilator therapy requires a thorough examination which may include visual inspection of the upper and lower airways with bronchoscopy. Computed tomography virtual bronchsocopy has been reported in a series of 10 burn patients as accurately identifying inhalational injury, but has yet to be shown to be equivalent or superior to bronchcoscopy.