COPD Is Associated With Adverse Events in Bronchoscopy

Though a comprehensive research bronchoscopy can be safely performed, certain individuals—including those with chronic obstructive pulmonary disease (COPD)—may be at an increased risk for experiencing procedure-related events that require intervention, according to results from the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS).

To evaluate the safety and tolerability of a bronchoscopy procedure that includes oral sampling, bronchoalveolar lavage, endobronchial biopsy, and brushing in individuals with COPD, the researchers evaluated the visual airway characteristics and adverse event occurrence (defined as events requiring intervention) among 215 participants. 

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Oral samples were obtained in at least 99% of participants, bronchoalveolar lavage yielded 111 ± 57 ml (50%) of the 223 ± 65 ml of infusate, endobronchial biopsies were performed in 82% of procedures, and brushes were completed in 98%.   

Airway characteristics were recorded in 99% of procedures. These visual airway characteristics were graded on a scale of 0 (normal appearance) to 3 (severe abnormality) in 4 domains: erythema, edema, secretions, and friability. In all, 61.9% of participants were free of edema, while less than 50% reported secretions, friability, or erythema.

Of the 208 bronchoscopies that were performed, 14 had events that required intervention. Having COPD was associated with these adverse events. Being a woman; having self-reported asthma, bronchodilator reversibility, or forced expiratory volume in 1 second; and experiencing secretions or friability during bronchoscopy also put individuals at a greater risk for adverse events.

“Airway characteristics during bronchoscopy, demographics, asthma or COPD, and lung function may convey increased risk for procedure-related events necessitating intervention,” the researchers concluded.

—Colleen Murphy

Reference:

Wells JM, Arenberg DA, Barjaktarevic I, et al. Safety and tolerability of comprehensive research bronchoscopy in chronic obstructive pulmonary disease. Results from the SPIROMICS bronchoscopy substudy. Ann Am Thorac Soc. 2019;16(4):431-432. https://doi.org/10.1513/AnnalsATS.201807-441OC.