Indications for flexible fiberoptic bronchoscopy and its safety in the very elderly

Abstract

Aim. To evaluate the indications and the safety of fiberoptic bronchoscopy (FOB) with bronchoalveolar lavage (BAL), protected specimen brushing (PSB), endobronchial biopsy (EBB), and transbronchial biopsy (TBB) in a population of very elderly patients. Methods. We performed a retrospective study of all adult patients, aged 50 years or older, who underwent FOB in the Bronchology Unit of the University of Parma Hospital between 1 January, 2003 and 31 April, 2005. Bronchoscopy records of 436 consecutive patients, including 191 patients, 75 yrs of age and older (“very elderly”; =>75 yrs), were reviewed. Results. Patients aged 75 years were no different with regard to gender, BMI, baseline FEV1/FVC ratio, baseline SaO2, and blood pressure. The primary indication in patients aged <75 years, was to assist in the diagnosis of a pulmonary mass of unknown aetiology (33%) and to remove secretions in the very elderly patients (31%). Indications for FOB and sampling procedures in the two groups were similar. Approximately 30% of patients in each group required supplemental oxygen during the procedure and fever occurred in 9.2% and 10.3% of patients, respectively.Hypertension and bleeding were relatively rare and did not occur more often in the very elderly. Conclusions. Indication for FOB did not vary with age and adverse events in both groups were uncommon and generally not severe.

Complications and discomfort of bronchoscopy: a systematic review

“…Six prospective studies (57, 58, 64–66, 72) and two retrospective studies (55, 73) listed pneumothorax as a potential outcome, with rates ranging from 0 to 4% (58, 72). Two studies reported no pneumothoraces in various bioptic techniques that included TBB (66, 72).…”

“…Three prospective studies (57, 74, 75) and one retrospective study with prospective recordings of bronchospasm (55) reported on bronchospasm. Bronchospasm occurred at a rate between 0 and 12.3% (57, 75).…”

“…Elevation of body temperature was reported in seven prospective studies (57, 65, 77, 84–87) and one retrospective study with prospective recordings of temperature (55). The studies comprised 50–539 subjects (57, 85).…”

Complications of Fiberoptic Bronchoscopy in Very Elderly Adults

“…To the Editor : Fiberoptic bronchoscopy is thought to be useful for diagnosing abnormalities in the lower respiratory tract and pulmonary parenchyma and is considered to be a safe method of examination, with a low rate of associated complications and mortality in the general population . However, the safety of fiberoptic bronchoscopy in very elderly adults has been evaluated in only a small number of studies and, before the present study, has never been evaluated in a prospective multicenter clinical trial . The aim of this prospective multicenter study was thus to compare the complications of fiberoptic bronchoscopy in very elderly adults with those in younger individuals.…”

The evolution of flexible bronchoscopy: From historical luxury to utter necessity!!

“…[ 1 ] Lung cancer was the indication behind its development and still is one of the commonest indications worldwide for flexible bronchoscopy. [ 3 4 5 ] Flexible bronchoscopy has a huge impact on the management of lung cancer. It helps in both diagnosing and staging lung cancer as well as palliation by debulking endobronchial lesions and treating airway stenoses by deploying metallic airway stents.…”