SummaryIntroductionFlexible bronchoscopes have become essential in the operating theatre environment and in critical care. This narrative review compared single‐use and reusable flexible bronchoscopes with a focus on safety, efficacy, cost‐effectiveness and environmental impact.MethodsWe searched MEDLINE, Embase and PubMed databases for studies related to flexible bronchoscopes for airway management or use in critical care. Human or animal studies of any design assessing single‐use and reusable flexible bronchoscopes were included and qualitatively synthesised. We also searched manufacturer websites for relevant data.ResultsWe included 52 studies and data from six manufacturer websites. There was mixed evidence for safety, and data on usability also showed significant heterogeneity, with different parameters, manufacturers and models examined. Neither single‐use nor reusable flexible bronchoscopes appeared convincingly superior to the other for safety or usability. Cost analyses showed that the rate of use of flexible bronchoscopes per year, along with several other factors, affects cost‐effectiveness for each institution, though the risk of cross‐contamination is an advantage of single‐use devices. However, sufficient evidence on the rate of bronchoscopy‐induced infection in the operating theatre and critical care environment is lacking. Due to the risk of cross‐contamination, single‐use flexible bronchoscopes must be sterilised or incinerated after use, and completely recyclable single‐use models are not currently available.ConclusionsFurther research is required on safety, usability and life cycle assessment in the operating theatre and critical care environment, as well as on the rate of bronchoscopy‐induced infection. Future comparative studies, including new manufacturers and designs, may lend further insights.

中文翻译：

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用于气道管理和重症监护的一次性使用与可重复使用的柔性支气管镜：叙述性回顾


摘要简介柔性支气管镜已成为手术室环境和重症监护中的必备品。这篇叙述性综述比较了一次性和可重复使用的柔性支气管镜，重点关注安全性、有效性、成本效益和环境影响。方法我们搜索了 MEDLINE、Embase 和 PubMed 数据库，查找与用于气道管理或重症监护的柔性支气管镜相关的研究。评估一次性和可重复使用的柔性支气管镜的任何设计的人体或动物研究都包括在内并进行了定性综合。我们还搜索了制造商网站以获取相关数据。结果我们纳入了来自 6 个制造商网站的 52 项研究和数据。安全性的证据好坏参半，可用性数据也显示出显着的异质性，检查的参数、制造商和型号也不同。无论是一次性使用的还是可重复使用的柔性支气管镜，在安全性或可用性方面都没有明显优于另一种。成本分析表明，尽管交叉污染的风险是一次性设备的一个优势，但每年柔性支气管镜的使用率以及其他几个因素都会影响每个机构的成本效益。然而，关于手术室和重症监护环境中支气管镜检查引起的感染率缺乏足够的证据。由于交叉污染的风险，一次性柔性支气管镜在使用后必须消毒或焚烧，目前还没有完全可回收的一次性型号。结论需要对手术室的安全性、可用性和生命周期评估进行进一步研究和重症监护环境，以及支气管镜检查引起的感染率。 未来的比较研究，包括新的制造商和设计，可能会提供进一步的见解。