An Audit of Complications during Various Flexible Bronchoscopic Interventions: A 4 Years Experience in a Tertiary Care Hospital

Abstract

Objective: To study the complication rate during a variety of bronchoscopic interventions.

Study Design: Observational / descriptive study.

Place and Duration of Study: This study was conducted at the Pulmonology Department, Services Institute of Medical Sciences/ Services Hospital Lahore from August 2012 to June 2016.

Material and Methods: 592 patients undergoing flexible bronchoscopic interventions for different indications in our department and severe complications associated with the bronchoscopic interventions were studied.

Results: A total of 592 patients were included. The major indication remained persistent lung infiltration in 85% patients, mediastinal lymphadenopathy in 4%, 3% had interstitial lung disease, hemoptysis in 2%, foreign body in 2%. Significant hemorrhage >50mls, occurred in 20 (3.37%) patients, mostly during endobronchial biopsies. Two out of total three pneumothorax occurred during TBB. Bronchospasm occurred in 22 (<3.7%) cases, mostly during BAL. Seizures and drowsiness occurred in 02 (0.5%) patients. Hypoxemia (SpO2<90%) was observed in 18 (3%) patients, mostly during BAL and EBB. 04 (0.67%) patients had supra-ventricular arrhythmias. 14 (2.4%) cases reported fever within 24 hours of procedure, out of which 07 (1.2%) had a new infiltrate/pneumonia on chest x-ray. One patient suffered myocardial infarction after 4 hours of the endobronchial biopsy.

Conclusion: Flexible bronchoscopy is a safe procedure with a low complication rate even during a variety of diagnostic and therapeutic interventions.