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. 1996 Jul;51(7):664–669. doi: 10.1136/thx.51.7.664

Safety of fibreoptic bronchoscopy in asthmatic and control subjects and effect on asthma control over two weeks.

M Humbert 1, D S Robinson 1, B Assoufi 1, A B Kay 1, S R Durham 1
PMCID: PMC472486  PMID: 8882070

Abstract

BACKGROUND: Concerns remain about the safety of bronchoscopy in asthma and there are few data on the effect of this procedure on asthma control in the days or weeks following bronchoscopy. METHODS: In an initial study of bronchoalveolar lavage and bronchial biopsies in asthmatic and control subjects, data on peak expiratory flow rates (PEFR) collected prospectively before and after the procedure were available from 21 of the 29 asthmatic subjects studied. These showed a median 23% fall in PEFR from baseline after bronchoscopy (range 3-58%). To determine whether this fall in PEFR following bronchoscopy reflected bronchospasm or the effect of sedation, PEFR and spirometric tests were performed during the two hours following bronchoscopy in a further study of 15 symptomatic asthmatic subjects and 20 non-asthmatic controls. To examine the effect on asthma control, asthmatic patients recorded PEFR, symptom scores, and medication use for two weeks before and after bronchoscopy. RESULTS: After bronchoscopy with bronchial biopsies there was no difference between the median maximal fall in either PEFR or arterial oxygen saturation between the 15 asthmatic patients (10.4% and 4%, respectively) and 20 controls (12% and 3%). Moreover, there were no significant changes in PEFR, symptom score, or medication use by the asthmatic subjects in the two weeks after bronchoscopy when compared with the two weeks before bronchoscopy. CONCLUSIONS: Fibreoptic bronchoscopy is well tolerated in asthmatic subjects. Falls in PEFR in both asthmatic and non-asthmatic subjects after bronchial biopsy may reflect the effects of sedation rather than bronchospasm. Additional bronchoalveolar lavage may cause bronchoconstriction. Careful monitoring is therefore essential. Peak flow monitoring up to two weeks after bronchoscopy with bronchial biopsy revealed no delayed effects on asthma control.

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Selected References

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

  1. Albertini R. E., Harrell J. H., 2nd, Kurihara N., Moser K. M. Arterial hypoxemia induced by fiberoptic bronchoscopy. JAMA. 1974 Dec 23;230(12):1666–1667. [PubMed] [Google Scholar]
  2. Bentley A. M., Meng Q., Robinson D. S., Hamid Q., Kay A. B., Durham S. R. Increases in activated T lymphocytes, eosinophils, and cytokine mRNA expression for interleukin-5 and granulocyte/macrophage colony-stimulating factor in bronchial biopsies after allergen inhalation challenge in atopic asthmatics. Am J Respir Cell Mol Biol. 1993 Jan;8(1):35–42. doi: 10.1165/ajrcmb/8.1.35. [DOI] [PubMed] [Google Scholar]
  3. Bousquet J., Chanez P., Lacoste J. Y., Barnéon G., Ghavanian N., Enander I., Venge P., Ahlstedt S., Simony-Lafontaine J., Godard P. Eosinophilic inflammation in asthma. N Engl J Med. 1990 Oct 11;323(15):1033–1039. doi: 10.1056/NEJM199010113231505. [DOI] [PubMed] [Google Scholar]
  4. Chetta A., Foresi A., Bertorelli G., Pesci A., Olivieri D. Lung function and bronchial responsiveness after bronchoalveolar lavage and bronchial biopsy performed without premedication in stable asthmatic subjects. Chest. 1992 Jun;101(6):1563–1568. doi: 10.1378/chest.101.6.1563. [DOI] [PubMed] [Google Scholar]
  5. Djukanović R., Roche W. R., Wilson J. W., Beasley C. R., Twentyman O. P., Howarth R. H., Holgate S. T. Mucosal inflammation in asthma. Am Rev Respir Dis. 1990 Aug;142(2):434–457. doi: 10.1164/ajrccm/142.2.434. [DOI] [PubMed] [Google Scholar]
  6. Djukanović R., Wilson J. W., Lai C. K., Holgate S. T., Howarth P. H. The safety aspects of fiberoptic bronchoscopy, bronchoalveolar lavage, and endobronchial biopsy in asthma. Am Rev Respir Dis. 1991 Apr;143(4 Pt 1):772–777. doi: 10.1164/ajrccm/143.4_Pt_1.772. [DOI] [PubMed] [Google Scholar]
  7. Gianiorio P., Bonavia M., Crimi E., Lantero S., Crimi P., Rossi G. A., Brusasco V. Bronchial responsiveness is not increased by bronchoalveolar and bronchial lavage performed after allergen challenge. Am Rev Respir Dis. 1991 Jan;143(1):105–108. doi: 10.1164/ajrccm/143.1.105. [DOI] [PubMed] [Google Scholar]
  8. Kelly C., Hendrick D., Walters H. The effect of bronchoalveolar lavage on bronchial responsiveness in patients with airflow obstruction. Chest. 1988 Feb;93(2):325–328. doi: 10.1378/chest.93.2.325. [DOI] [PubMed] [Google Scholar]
  9. Kirby J. G., O'Byrne P. M., Hargreave F. E. Bronchoalveolar lavage does not alter airway responsiveness in asthmatic subjects. Am Rev Respir Dis. 1987 Mar;135(3):554–556. doi: 10.1164/arrd.1987.135.3.554. [DOI] [PubMed] [Google Scholar]
  10. Robinson D. S., Bentley A. M., Hartnell A., Kay A. B., Durham S. R. Activated memory T helper cells in bronchoalveolar lavage fluid from patients with atopic asthma: relation to asthma symptoms, lung function, and bronchial responsiveness. Thorax. 1993 Jan;48(1):26–32. doi: 10.1136/thx.48.1.26. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Robinson D. S., Hamid Q., Ying S., Tsicopoulos A., Barkans J., Bentley A. M., Corrigan C., Durham S. R., Kay A. B. Predominant TH2-like bronchoalveolar T-lymphocyte population in atopic asthma. N Engl J Med. 1992 Jan 30;326(5):298–304. doi: 10.1056/NEJM199201303260504. [DOI] [PubMed] [Google Scholar]
  12. Rosenow E. C., Andersen H. A. Bronchoscopically induced bronchospasm. Chest. 1976 Oct;70(4):565–566. doi: 10.1378/chest.70.4.565. [DOI] [PubMed] [Google Scholar]
  13. Sahn S. A., Scoggin C. Fiberoptic bronchoscopy in bronchial asthma. A word of caution. Chest. 1976 Jan;69(1):39–42. doi: 10.1378/chest.69.1.39. [DOI] [PubMed] [Google Scholar]
  14. Smith D. L., Deshazo R. D. Bronchoalveolar lavage in asthma. An update and perspective. Am Rev Respir Dis. 1993 Aug;148(2):523–532. doi: 10.1164/ajrccm/148.2.523. [DOI] [PubMed] [Google Scholar]
  15. Van Vyve T., Chanez P., Bousquet J., Lacoste J. Y., Michel F. B., Godard P. Safety of bronchoalveolar lavage and bronchial biopsies in patients with asthma of variable severity. Am Rev Respir Dis. 1992 Jul;146(1):116–121. doi: 10.1164/ajrccm/146.1.116. [DOI] [PubMed] [Google Scholar]

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