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

Authors Grendelmeier P, Tamm M, Jahn K, Pflimlin E, Stolz D

Received 12 August 2016

Accepted for publication 9 November 2016

Published 4 January 2017 Volume 2017:12 Pages 177—187

DOI https://doi.org/10.2147/COPD.S119575

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Charles Downs

Peer reviewer comments 4

Editor who approved publication: Dr Richard Russell

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

Clinic of Pulmonary Medicine and Respiratory Cell Research, University Hospital Basel, Petersgraben, Basel, Switzerland

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, propofol, complication, risk, respiratory insufficiency

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