Chest
Original Research: Interventional PulmonologyA Randomized, Placebo-Controlled Trial of Bronchodilators for Bronchoscopy in Patients With COPD
Section snippets
Materials and Methods
A total of 120 patients undergoing diagnostic flexible bronchoscopy at the University Hospital Basel (Basel, Switzerland) between June and October 2005 were recruited for this study. This study was approved by the Ethic Committee of the University Hospital Basel.
Results
Demographic and lung function parameters are presented inTable 1. Patients with COPD randomized to salbutamol and placebo groups were similar in regard to age, gender distribution, and spirometric findings. The majority of the patients with COPD had moderate (43%) or severe (32.5%) disease, according to the GOLD stage classification.19Historical data from the lung function laboratory were available for 66 of the subjects (82.5%) with COPD. Lung function testing was performed at a median
Discussion
This study demonstrates that there is no benefit of inhaled short-acting β-agonists prior to bronchoscopy in patients with COPD. The inhalation of salbutamol neither improved safety nor prevented decrease in FEV1. Thus, routine inhalation of a short-acting β-agonist cannot be recommended as a premedication for bronchoscopy in COPD patients.
Most of the literature regarding the investigative use of bronchoscopy relates to its use in asthma.11There is a more pronounced postbronchoscopic fall in FEV
Acknowledgments
We are deeply grateful to the endoscopy staff (Esther Gysin, Dusan Jovic, Bjorn Fehrke, Monika Kohler, Sylvie Groelly, Michael Ortmann, Beatrice Lehner, Brigitte Koch, Margot Brenneisen) for their collaboration; to Anja Meyer, RN, for her enthusiastic cooperation in data collection; and to Andy Schoetzau for statistical assistance.
References (36)
- et al.
Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study
Lancet
(1997) - et al.
Complications of fiberoptic bronchoscopy at a university hospital
Chest
(1995) - et al.
Self-expandable metallic airway stents and flexible bronchoscopy: long-term outcomes analysis
Chest
(2003) New and emerging minimally invasive techniques for lung volume reduction
Chest
(2004)- et al.
Bronchoalveolar lavage: its safety in subjects with mild asthma
Chest
(1984) - et al.
Safety of bronchoscopy, biopsy, and BAL in research patients with COPD
Chest
(2002) - et al.
Management of hypoxemia during flexible bronchoscopy
Clin Chest Med
(2003) - et al.
Nebulized lidocaine for flexible bronchoscopy: a randomized, double-blind, placebo-controlled trial
Chest
(2005) - et al.
Bronchoalveolar lavage causes decrease in PaO2, increase in (A-a) gradient value and bronchoconstriction in asthmatics
Respir Med
(1998) - et al.
Modification of the effect of fiberoptic bronchoscopy on pulmonary mechanics
Chest
(1981)
The effects of fiberoptic bronchoscopy with and without atropine premedication on pulmonary function in humans
Ann Thorac Surg
The response to atropine sulfate given by aerosol and intramuscular routes to patients undergoing fiberoptic bronchoscopy
Chest
Sedation for fibre optic bronchoscopy
Respir Med
Sedation for fibreoptic bronchoscopy: comparison of alfentanil with papaveretum and diazepam
Respir Med
Thorax
Morbidity and mortality: 2002 chartbook on cardiovascular, lung and blood diseases
National Institutes of Health
Diagnostic yield of flexible bronchoscopy in current clinical practice
Swiss Med Wkly
Investigative bronchoprovocation and bronchoscopy in airway diseases
Am J Respir Crit Care Med
Cited by (24)
Acute Exacerbations of Chronic Obstructive Pulmonary Disease
2014, Mandell, Douglas, and Bennett's Principles and Practice of Infectious DiseasesGuidance on sedation and anesthesia protocols for diagnostic and therapeutic procedures (Ⅲ)
2023, Chinese Journal of AnesthesiologyComplications and safety analysis of diagnostic bronchoscopy in COPD: a systematic review and meta-analysis
2022, Expert Review of Respiratory MedicineComplications and discomfort after research bronchoscopy in the MicroCOPD study
2020, BMJ Open Respiratory ResearchGuideline for diagnostic flexible bronchoscopy in adults (2019)
2019, Zhonghua Jiehe he Huxi Zazhi / Chinese Journal of Tuberculosis and Respiratory DiseasesIs bronchodilator the correct treatment for COPD subjects before EBUS?
2017, Journal of Thoracic Disease
This work was funded by the Clinic of Respiratory Medicine, University Hospital Basel. The authors have no conflicts of interest to disclose.