You are here

Article Text

Article menu

Download PDFPDF

XML
Respiratory research
Complications and discomfort after research bronchoscopy in the MicroCOPD study
  1. Elise Orvedal Leiten1,
  2. Tomas Mikal Lind Eagan1,2,
  3. Einar Marius Hjellestad Martinsen1,
  4. Eli Nordeide2,
  5. Gunnar Reksten Husebø1,2,
  6. Kristel Svalland Knudsen2,
  7. Sverre Lehmann1,2,
  8. Øistein Svanes1,2,
  9. Per Sigvald Bakke1 and
  10. Rune Nielsen1,2
  1. 1Department of Clinical Science, University of Bergen, Bergen, Norway
  2. 2Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
  1. Correspondence to Dr Elise Orvedal Leiten; elise.leiten{at}uib.no

Abstract

Background Data on discomfort and complications from research bronchoscopy in chronic obstructive pulmonary disease (COPD) and asthma is limited. We present complications and discomfort occurring within a week after bronchoscopy, and investigate personal and procedural risk factors.

Methods 239 subjects with COPD, asthma or without lung disease underwent research bronchoscopies as part of a microbiome study of the lower airways (the MicroCOPD study). Bronchoscopy was done in the supine position with oral scope insertion with the option of light conscious alfentanil sedation. Sampling consisted of protected specimen brushes, bronchoalveolar lavage, small volume lavage and for some, endobronchial biopsies. Bleeding, desaturation, cough, haemodynamic changes, dyspnoea and other events that required an unplanned intervention or early termination of bronchoscopy were prospectively recorded. Follow-up consisted of a telephone interview where subjects rated discomfort and answered questions about fever sensation and respiratory symptoms in the week following bronchoscopy.

Results An unplanned intervention or early termination of bronchoscopy was required in 25.9% of bronchoscopies. Three subjects (1.3%) experienced potentially severe complications, of which all recovered without sequelae. COPD subjects experienced more dyspnoea than controls. Sedation and lower age was associated with less unplanned intervention or premature termination. About half of the subjects (47.7%) reported fever. Discomfort was associated with postprocedural fever, dread of bronchoscopy, higher score on the COPD Assessment Test and never-smoking. In subjects undergoing more than one bronchoscopy, the first bronchoscopy was often predictive for complications and postprocedural fever in the repeated bronchoscopy.

Conclusion Research bronchoscopies were not associated with more complications or discomfort in COPD subjects. 47.7% experienced postbronchoscopy fever sensation, which was associated with discomfort.

  • bronchoscopy
  • COPD epidemiology
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjresp-2019-000449

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Presented at An early version of this work was presented in poster form September 12th 2017 at the European Respiratory Society International Congress in Milan.

    • Contributors EOL had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. EOL, TMLE, EMHM, EN, GRH, KSK, SL, ØS and RN participated in different aspects of data collection. TMLE, GRH, KSK, SL, ØS and RN performed the bronchoscopies. EOL, TMLE, EMHM, EN, GRH, KSK, SL, ØS, PSB and RN contributed substantially to the study design, data analysis and interpretation, and the writing of the manuscript.

    • Funding The MicroCOPD study was funded by unrestricted grants and fellowships from Helse Vest, Bergen Medical Research Foundation, the Endowment of Timber Merchant A. Delphin and Wife through the Norwegian Medical Association and GlaxoSmithKline through the Norwegian Respiratory Society.

    • Competing interests EOL, EMHM, EN, KSK, ØS and PSB declare no competing interests. TMLE has for the last three years received lecture fees from Boehringer Ingelheim, Roche and Astra Zeneca. GRH has for the last three years received lecture fees from Novartis and Boehringer Ingelheim. RN reports grants from GlaxoSmithKline, during the conduct of the study; grants from Boehringer Ingelheim, grants and personal fees from AstraZeneca, grants from Novartis, personal fees from GlaxoSmithKline, outside the submitted work. SL has for the last three years received lecture fees from Philips, Novartis and Astra Zeneca, and advisory board fees (paid to employer) from Novartis and Astra Zeneca, all outside the submitted work.

    • Patient consent for publication Not required.

    • Ethics approval The Regional Committee for Medical and Health Research Ethics approved the project (REK VEST 2011/1307). All participants provided written informed consent.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement The data and command lines necessary for running the analyses presented in this article are available upon reasonable request.