Safety of Bronchoscopy, Biopsy, and BAL in Research Patients with COPD

Hattotuwa, Keith; Gamble, Elizabeth; O'Shaughnessy, T; Jeffery, Peter K.; Barnes, Neil

doi:10.1378/chest.122.6.1909

Cited by 76 publications

(63 citation statements)

References 14 publications

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“…Prolonged coughing and transient decreases of oxygen saturations (lowest 88%) occurred in the enrolled patients during BAL, treated successfully with supplemental oxygen. Low incidence of adverse events needing hospital treatment (2%) and low incidence of hemoptysis which resolved spontaneously (3%), were reported in the study, concluding that fiberoptic bronchoscopy, endobronchial biopsies, and BAL can be carried out in selected patients with COPD with a low incidence of adverse events (14).…”

supporting

confidence: 57%

Is bronchodilator the correct treatment for COPD subjects before EBUS?

Leoni¹,

Pignatti²,

Visca³

et al. 2017

J. Thorac. Dis.

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Endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA) is a relatively novel, minimally invasive methodology to sample peribronchial masses with real-time guidance (1,2), widely used all over the world. The most common indications for EBUS are the staging of the mediastinum for suspected non-small cell lung cancer and the diagnosis of unexplained mediastinal lymphadenopathy. Usually EBUS is well tolerated, with very few major contraindications; guidelines suggest that patients who experienced myocardial infarction should wait 6 weeks before the procedure, which is however contraindicated when myocardial ischemia, arrhythmias, severe hypoxemia at rest, coagulation or platelet function disorders are present (1).EBUS-TBNA is less available and more expensive than rigid bronchoscopy (RB) which remains the best choice for extraction of airway foreign bodies, when a flexible scope is not suited or in case of large biopsies. However, the diagnostic power of RB in terms of lung cancer staging or evaluation of peripheral pulmonary lesions is lower compared to EBUS-TBNA (3) in the general population and speculatively in COPD patients.

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supporting

confidence: 57%

Is bronchodilator the correct treatment for COPD subjects before EBUS?

Leoni¹,

Pignatti²,

Visca³

et al. 2017

J. Thorac. Dis.

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“…Investigative bronchoscopy is considered to be safe in asthmatic subjects (Hattotuwa et al, 2002) It is well tolerated even in those with severe asthma. Asthma exacerbations are rare and reduction in pulmonary function after the procedure is similar to that in subjects with less severe asthma (Moore et al, 2011).…”

Section: Risks and Benefitsmentioning

confidence: 99%

Fevipiprant, a prostaglandin D 2 receptor 2 antagonist, in patients with persistent eosinophilic asthma: a single-centre, randomised, double-blind, parallel-group, placebo-controlled trial

Gonem

Berair

Singapuri

et al. 2016

The Lancet Respiratory Medicine

228

190

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“…The number of applications for FOB procedures in elderly patients will likely grow tremendously in the near future with expanding applications in clinical medicine [11] and research [12][13][14]. In particular, the role of FOB procedures in lung cancer continues to expand.…”

Section: Introductionmentioning

confidence: 99%

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

D’Ippolito

Foresi²,

Castagnetti

et al. 2016

Monaldi Arch Chest Dis

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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.

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Safety of Bronchoscopy, Biopsy, and BAL in Research Patients with COPD

Cited by 76 publications

References 14 publications

Is bronchodilator the correct treatment for COPD subjects before EBUS?

Is bronchodilator the correct treatment for COPD subjects before EBUS?

Fevipiprant, a prostaglandin D 2 receptor 2 antagonist, in patients with persistent eosinophilic asthma: a single-centre, randomised, double-blind, parallel-group, placebo-controlled trial

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

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