Bronchoscopy is associated with decreased mesenteric arterial flow.
BACKGROUND
We hypothesized that fiberoptic bronchoscopy can contribute to mesenteric ischemia and bacterial translocation.


OBJECTIVE
To test this hypothesis we investigated in patients undergoing bronchoscopy mesenteric blood flow and markers in association with ischemia reperfusion injury.


METHODS
Forty-seven consecutive patients requiring diagnostic fiberoptic bronchoscopy were studied.


METHODS
Parameters evaluated were superior mesenteric artery Doppler sonography, oxidative stress mediators, arterial blood gases, blood cultures pre-fiberoptic bronchoscopy, and 1st, 4th, and 24th hr post-fiberoptic bronchoscopy.


RESULTS
After bronchoscopy; PaO2 decreased by 21.8% +/- 1.5% (range 6-40), and remained low at all time points (p = 0.0001, p = 0.0001, p = 0.008). Flow volume decreased by 38.8% +/- 14.9% (range 6-72), and remained low at 1st and 4th hr (p = 0.0001, p = 0.01). Resistive and pulsatile index increased at 1st hr (p = 0.0001, p = 0.001) and 4th hr (p = 0.018, p = 0.045). Myeloperoxidase and malondialdehyde increased at 1st hr (p = 0.0001) and 4th hr (p = 0.037, p = 0.028). Corresponding glutathione and catalase decreased at 1st hr (p = 0.0001), and glutathione remained significant at 4th and 24th hr (p = 0.0001, p = 0.003). Correlation between flow volume and PaO2 (r = .71, p = 0.0001), myeloperoxidase (r = -.39, p = 0.05), glutathione (r = .41, p = 0.03) was significant. Nine of 47 (19.1%) had fever, and 3 of 47 (6.4%) had gram-negative bacteremia.


CONCLUSIONS
Fiberoptic bronchoscopy is associated with decreased mesenteric blood flow, which may place the patient at risk for mesenteric ischemia and gastrointestinal bacterial translocation.
Nayci
Ali
A
Department of Pediatric Surgery, Mersin University School of Medicine, Mersin Turkey. anayci@mersin.edu.tr
Atis
Sibel
S
Duce
Meltem Nass
MN
Bayindir
Suzan
S
Tamer
Lulufer
L
Ozturk
Candan
C
D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000209:etiology; D018988:Bacterial Translocation; D015415:Biomarkers / Q000097:blood; D001999:Bronchoscopy / Q000009:adverse effects*; D005260:Female; D005336:Fiber Optic Technology; D006090:Gram-Negative Bacteria / Q000502:physiology; D006785:Hospitals, University; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000503:physiopathology*; D008875:Middle Aged; D018384:Oxidative Stress; D015427:Reperfusion Injury / Q000209:etiology* / Q000503:physiopathology; D013152:Splanchnic Circulation
D015415:Biomarkers