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. 2017 Jan 4:12:177-187.
doi: 10.2147/COPD.S119575. eCollection 2017.

Flexible bronchoscopy with moderate sedation in COPD: a case-control study

Peter Grendelmeier  1 , Michael Tamm  1 , Kathleen Jahn  1 , Eric Pflimlin  1 , Daiana Stolz  1
Affiliations

Flexible bronchoscopy with moderate sedation in COPD: a case-control study

Peter Grendelmeier et al. Int J Chron Obstruct Pulmon Dis. .

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 PtcCO2 and time on PtcCO2 >45 mmHg were higher in the COPD group. There were no differences in patient-reported outcomes.

Conclusion: 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.

Keywords: bronchoalveolar lavage; complication; propofol; respiratory insufficiency; risk.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study design.
Figure 2
Figure 2
Hemodynamic parameters and need for supplemental oxygen in 1,092 patients undergoing flexible bronchoscopy (FB) based on the presence or absence of COPD. Notes: Black boxes represent patients without COPD and gray boxes represent patients with COPD. P-values compare hemodynamic parameters, including oxygen requirement, and transcutaneous PtcCO2 change over time course between the COPD and non-COPD patient groups using mixed linear models. Abbreviations: BP, blood pressure; min, minutes; PtcCO2, transcutaneous carbon dioxide tension.
Figure 3
Figure 3
Transcutaneous carbon dioxide tension in a nested-cohort of 220 patients undergoing flexible bronchoscopy based on the presence or absence of COPD. Black boxes represent patients without COPD and gray boxes represent patients with COPD. Abbreviations: FB, flexible bronchoscopy; PtcCO2, transcutaneous carbon dioxide tension.
See this image and copyright information in PMC

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