Spectrum of Complications in Patients Undergoing Fiberoptic Bronchoscopy
Complications in fiberoptic bronchoscopy
Abstract
Background: Flexible fiberoptic bronchoscopy is a basic and essential procedure in the field of interventional Pulmonology. It is among the bronchoscopic procedures performed most commonly. Although it is relatively safe, effective and well tolerated procedure, there are still a number of complications that can occur which are important and steps should be taken to prevent them to improve the quality of the procedure.
Aim: The purpose of the study was to determine the spectrum of complications in patients undergoing fiberoptic bronchoscopy at Sher I Kashmir Institute of Medical Sciences (SKIMS-Srinagar, Kashmir), a tertiary care hospital in the valley of Kashmir.
Materials and Methods: This prospective descriptive study included 70 consecutive adult patients between 18-82 years (mean 55.221), who underwent fiberoptic bronchoscopy in the Pulmonary lab, carried out by four experienced bronchoscopists (>10 years of experience) from the department of Internal and Pulmonary Medicine. Patient’s demographic profile, medical history, smoking history, covid status, bronchoscopic indications, and relevant blood tests performed within 48 hours prior bronchoscopy. Bronchoscopic findings and complications were recorded in the preformed proforma at the time of enrolment in the study.
Results: Out of 70 patients, 49 (70%) were male and 21 (30%) were female. Lung mass (34.3%), hemoptysis (20%), non-resolving consolidation (14.3%), and chronic cough (12.9%) were most common indications. Bronchoscopic complications were seen in 22 patients (31.4%), including bleeding (9 cases), arrhythmia (6 cases), hypoxemia (3 cases), and others like epistaxis and vomiting in 2 cases. Multiple complications occurred in 2 cases. These complications were managed conservatively and all patients recovered without any serious consequences. No major complication occurred and mortality rate was 0%. The frequency of radiographic mass lesion was more common in smokers (ex or current) 52% (25/48), than in non-smokers 27.3% (6/22) and bronchoscopically mass lesion was found in 39.6% (19/48) smokers (ex or current) and 27.3% (6/22) non –smokers. There was no association between complication and age. There was significant association of bronchoscopic complications with bronchoscopic findings and bronchoscopic interventions. (P = 0.001).
Conclusion: According to the results obtained, the complications occurred were minor with only one case of severe bleeding and that too was managed conservatively. No major adverse complications were recorded. Thus, it may be concluded that flexible fiberoptic bronchoscopy is safe and should be performed wherever indicated with all the backup needed to tackle the complications
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