title: Bronchoscopy Safety in Patients With Chronic Obstructive Lung Disease.
abstract: BACKGROUND
  Flexible bronchoscopy is a safe and minimally invasive diagnostic tool used by pulmonologists, but few studies have prospectively compared outcomes in patients with objectively defined obstructive lung disease to those without obstruction.
  
  
  METHODS
  We determined whether complications in patients undergoing moderate sedation bronchoscopy differ in those without obstruction compared with chronic obstructive pulmonary disease (COPD). We prospectively followed all patients undergoing moderate sedation bronchoscopy in an inpatient or outpatient setting.
  
  
  RESULTS
  Over 12 months, data were collected prospectively in 258 patients. A total o 151 patients had pulmonary function testing with classification of COPD according to GOLD Criteria. Sixty-seven of those patients (44%) had COPD: 6 mild (9%), 29 moderate (42%), 27 severe (41%), and 5 very severe (8%). COPD patients were more likely to receive outpatient inhaled corticosteroids and long-acting bronchodilators and anticholinergics (P<0.001) as would be clinically appropriate. Among all patients with COPD, there were 13% minor complications and 5% major complications, with no deaths. Respiratory complications occurred more often in patients with severe to very severe COPD (22%) compared with patients without COPD (6%) (P=0.018). When adjusted for age, body mass index, and use of home oxygen, this difference was still significant (P=0.045).
  
  
  CONCLUSIONS
  Bronchoscopy is generally safe with few complications in most patients with COPD. Patients with objectively confirmed severe to very severe COPD had more frequent respiratory complications than patients without COPD. The risks were not prohibitively high, but should be taken into consideration for COPD patients undergoing moderate sedation flexible bronchoscopy.
authors.affiliation: *Department of Pulmonary/Critical Care, Wake Forest Baptist Health†Salem Chest Specialists, Winston Salem, NC.
authors.forename: Christina R
authors.initials: CR
authors.lastname: Bellinger
authors.forename: Irtaza
authors.initials: I
authors.lastname: Khan
authors.forename: Arjun B
authors.initials: AB
authors.lastname: Chatterjee
authors.forename: Edward F
authors.initials: EF
authors.lastname: Haponik
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D001706:Biopsy; D018893:Bronchoalveolar Lavage; D001993:Bronchodilator Agents / Q000627:therapeutic use; D001999:Bronchoscopy / Q000379:methods*; D016022:Case-Control Studies; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D015331:Cohort Studies; D016292:Procedural Sedation; D003371:Cough / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000628:therapy; D012720:Severity of Illness Index; D003074:Solitary Pulmonary Nodule / Q000150:complications / Q000175:diagnosis*; D014797:Vital Capacity
chemical_list: D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists