title: Flexible bronchoscopy with moderate sedation in COPD: a case-control study.
abstract: BACKGROUND
  Flexible bronchoscopy is increasingly used for diagnostic and therapeutic purposes. We aimed to examine the safety of flexible bronchoscopy with moderate sedation in patients with COPD.
  
  
  METHODS
  This study is a prospective, longitudinal, case-control, single-center study including 1,400 consecutive patients. After clinical and lung function assessments, patients were dichotomized in COPD or non-COPD groups. The primary end point was the combined incidence of complications.
  
  
  RESULTS
  The incidence of complications was similar in patients with and without COPD and independent of forced expiratory volume in the first second % predicted. Patients with COPD more frequently required insertion of a naso- or oropharyngeal airway; however, this difference was no longer significant after adjustment for age, gender, and duration of the procedure. Hypotension was significantly more common among patients with COPD. The number of episodes of hypoxemia ≤90% did not differ between the groups. However, patients with COPD had a lower mean and nadir transcutaneous oxygen saturation. Transcutaneous carbon dioxide tension (PtcCO2) change over the time course was similar in both groups, but both peak PtcCO2and time on PtcCO2>45 mmHg were higher in the COPD group. There were no differences in patient-reported outcomes.
  
  
  CONCLUSIONS
  The safety of flexible bronchoscopy is similar in patients with and without COPD. This finding confirms the suitability of the procedure for both clinical and research indications.
authors.affiliation: Clinic of Pulmonary Medicine and Respiratory Cell Research, University Hospital Basel, Petersgraben, Basel, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Grendelmeier
authors.affiliation: Clinic of Pulmonary Medicine and Respiratory Cell Research, University Hospital Basel, Petersgraben, Basel, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Tamm
authors.affiliation: Clinic of Pulmonary Medicine and Respiratory Cell Research, University Hospital Basel, Petersgraben, Basel, Switzerland.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Jahn
authors.affiliation: Clinic of Pulmonary Medicine and Respiratory Cell Research, University Hospital Basel, Petersgraben, Basel, Switzerland.
authors.forename: Eric
authors.initials: E
authors.lastname: Pflimlin
authors.affiliation: Clinic of Pulmonary Medicine and Respiratory Cell Research, University Hospital Basel, Petersgraben, Basel, Switzerland.
authors.forename: Daiana
authors.initials: D
authors.lastname: Stolz
mesh_terms: D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods*; D016022:Case-Control Studies; D016292:Procedural Sedation / Q000009:adverse effects; D005260:Female; D005541:Forced Expiratory Volume; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology; D000860:Hypoxia / Q000097:blood / Q000209:etiology; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D013557:Switzerland; D014797:Vital Capacity
chemical_list: D018686:Anesthetics, Intravenous; D010100:Oxygen; D015742:Propofol
keywords: bronchoalveolar lavage; complication; propofol; respiratory insufficiency; risk