Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1975 Aug;30(4):441–446. doi: 10.1136/thx.30.4.441

Effect of fiberoptic bronchoscopy on respiratory performance in patients with chronic airways obstruction.

B G Salisbury, L F Metzger, M D Altose, N N Stanley, N S Cherniack
PMCID: PMC470306  PMID: 1179328

Abstract

Lung volumes, airway resistance, expiratory flow rates, distribution of ventilation, and arterial blood gases were measured before and after fiberoptic bronchoscopy in 13 patients with moderately severe chronic airways obstruction and in 10 healthy non-smoking controls. Arterial blood gases were also monitored serially during the procedure. Arterial oxygen tension (Pao2) fell during fiberoptic bronchoscopy in both patients and controls whereas arterial carbon dioxide tension and pH remained unchanged. Control subjects had no change in lung mechanics after fiberoptic bronchoscopy. However, the patients consistently developed increased airway obstruction after fiberoptic bronchoscopy. Within 24 hours after bronchoscopy lung function in the patients returned to baseline values, except for the residual volume which remained abnormally high. The topical application of lignocaine (Lidocaine) for local anesthesia before fiberoptic bronchoscopy produced no effect on lung mechanics in nine patients and 10 controls, but Pao2 decreased in both the patient and control groups. These results indicate that fiberoptic bronchoscopy consistently inpairs lung mechanics and gas exchange in patients with chronic airways obstruction but that the impairment is mild and reversible. Lignocaine administration as well as the intubation procedure contribute to the fall in Pao2 which occurs both in the patients and in subjects without pre-existing lung disease.

Full text

PDF
441

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albertini R., Harrel J. H., Moser K. M. Letter: Hypoxemia during fiberoptic bronchoscopy. Chest. 1974 Jan;65(1):117–118. doi: 10.1378/chest.65.1.117. [DOI] [PubMed] [Google Scholar]
  2. Anthonisen N. R., Danson J., Robertson P. C., Ross W. R. Airway closure as a function of age. Respir Physiol. 1969 Dec;8(1):58–65. doi: 10.1016/0034-5687(69)90044-9. [DOI] [PubMed] [Google Scholar]
  3. BRISCOE W. A., DUBOIS A. B. The relationship between airway resistance, airway conductance and lung volume in subjects of different age and body size. J Clin Invest. 1958 Sep;37(9):1279–1285. doi: 10.1172/JCI103715. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. COMROE J. H., Jr, FOWLER W. S. Lung function studies. VI. Detection of uneven alveolar ventilation during a single breath of oxygen. Am J Med. 1951 Apr;10(4):408–413. doi: 10.1016/0002-9343(51)90285-9. [DOI] [PubMed] [Google Scholar]
  5. Credle W. F., Jr, Smiddy J. F., Elliott R. C. Complications of fiberoptic bronchoscopy. Am Rev Respir Dis. 1974 Jan;109(1):67–72. doi: 10.1164/arrd.1974.109.1.67. [DOI] [PubMed] [Google Scholar]
  6. DUBOIS A. B., BOTELHO S. Y., BEDELL G. N., MARSHALL R., COMROE J. H., Jr A rapid plethysmographic method for measuring thoracic gas volume: a comparison with a nitrogen washout method for measuring functional residual capacity in normal subjects. J Clin Invest. 1956 Mar;35(3):322–326. doi: 10.1172/JCI103281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. FORKE M. E., SCHOEMPERLEN C. B., CHERNIACK R. M. Alveolar ventilation during bronchoscopy. Dis Chest. 1962 Sep;42:311–314. doi: 10.1378/chest.42.3.311. [DOI] [PubMed] [Google Scholar]
  8. GOLDMAN H. I., BECKLAKE M. R. Respiratory function tests; normal values at median altitudes and the prediction of normal results. Am Rev Tuberc. 1959 Apr;79(4):457–467. doi: 10.1164/artpd.1959.79.4.457. [DOI] [PubMed] [Google Scholar]
  9. Kleinholz E. J., Fussell J., McBrayer R. Arterial blood gas studies during fiberoptic bronchoscopy. Am Rev Respir Dis. 1973 Oct;108(4):1014–1014. doi: 10.1164/arrd.1973.108.4.1014. [DOI] [PubMed] [Google Scholar]
  10. McCarthy D. S., Spencer R., Greene R., Milic-Emili J. Measurement of "closing volume" as a simple and sensitive test for early detection of small airway disease. Am J Med. 1972 Jun;52(6):747–753. doi: 10.1016/0002-9343(72)90080-0. [DOI] [PubMed] [Google Scholar]
  11. Thomson P. D., Melmon K. L., Richardson J. A., Cohn K., Steinbrunn W., Cudihee R., Rowland M. Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans. Ann Intern Med. 1973 Apr;78(4):499–508. doi: 10.7326/0003-4819-78-4-499. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES