Chest
Volume 107, Issue 2, February 1995, Pages 430-432
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Clinical Investigations: Techniques
Complications of Fiberoptic Bronchoscopy at a University Hospital

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Study objective

To retrospectively review the indications and complications associated with flexible fiberoptic bronchoscopy (FFB) in a university teaching hospital.

Design

Retrospective review from April 1, 1988 to March 30, 1993.

Setting

Large tertiary care university hospital.

Patients or participants

We reviewed 4,273 consecutive FFBs, including 2,493 bronchoalveolar lavages and 173 transbronchial biopsy procedures.

Interventions

None

Results

Most (52%) FFBs were performed for obtaining lower respiratory tract samples for evaluation of suspected infection. An additional 17% were performed to evaluate an abnormality seen on chest radiograph. The most common therapeutic indication was removal of retained secretions in 8% of FFBs. The mortality rate was 0%, and the frequency of major and minor complications was 0.5% and 0.8%, respectively. The incidence of major complications secondary to transbronchial biopsy was 6.8%.

Conclusions

Flexible fiberoptic bronchoscopy can be performed safely in a teaching hospital with appropriate preparation, supervision, and adherence to protocol.

Section snippets

Data Collection

This retrospective study reviewed 4,273 consecutive bronchoscopy reports of FFBs performed at The Ohio State University Hospitals between April 1, 1988 and March 30, 1993. Each FFB report, completed by the attending physician and the bronchoscopy technician, contained the indication, anesthesia, findings, and complications. There was a standard protocol for filling out each bronchoscopy report and for observing the patient for postbronchoscopy complications. The patient was observed for

Indications

Of the 4,273 bronchoscopies performed, 3,686 (86.3%) were performed for diagnostic purposes, 447 (10.4%) for therapeutic purposes, and 140 (3.3%) were performed on normal volunteers for research purposes. These procedures included 2,493 BALs and 173 transbronchial biopsies. The major diagnostic indications included obtaining lower respiratory tract secretions for suspected infection (52% of all FFBs), evaluating lung lesions of unknown etiology observed on chest radiograph (17% of all FBB),

DISCUSSION

Credle et al2 first reviewed the complications of fiberoptic bronchoscopy in 1974 by a questionnaire sent to 250 physicians. Seventy-eight percent responded with a total of 24,521 procedures reported. The mortality rate was 0.01% and the incidence of major complications was 0.08%. In a similar study, Suratt et al3 surveyed 1,041 owners of flexible fiberoptic bronchoscopes. Thirty-one percent responded for a total of 48,000 procedures. Mortality rate was 0.03% and the incidence of major

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