Bronchoscopy Health Article

Normal results

If the results of the bronchoscopy are normal, the windpipe (trachea) appears as smooth muscle with C-shaped rings of cartilage at regular intervals. There are no abnormalities either in the trachea or in the bronchi of the lungs.

Bronchoscopy results may also confirm a suspected diagnosis. This may include swelling, ulceration, or deformity in the bronchial wall, such as inflammation, stenosis, or compression of the trachea, neoplasm, and foreign bodies. The bronchoscopy may also reveal the presence of atypical substances in the trachea and bronchi. If samples are taken, the results could indicate cancer, disease-causing agents, or other lung diseases. Other findings may include constriction or narrowing (stenosis), compression, dilation of vessels, or abnormal branching of the bronchi. Abnormal substances that might be found in the airways include blood, secretions, or mucous plugs.

Morbidity and mortality rates

Bronchoscopy belongs to the group of procedures associated with highest inpatient mortality with a 12.7% mortality rate.

Alternatives

Depending upon the purpose of the bronchoscopy, alternatives may include a chest x ray or a computed tomography (CT) scan. If the purpose is to obtain biopsy specimens, one option is to perform surgery, which carries greater risks. Another option is percutaneous biopsy guided by CT.

BOOKS

Bolliger, C. T., and P. N. Mathur, eds. Interventional Bronchoscopy. (Progress in Respiratory Research, Vol. 30). Basel: S. Karger Publishing, 1999.

Koppen, W., J. F. Turner, and A. C. Mehta, eds. Flexible Bronchoscopy. 2nd ed. Oxford: Blackwell Publishers, 2004.

Loeb, S., ed. Illustrated Guide to Diagnostic Tests. Springhouse, PA: Springhouse Corporation, 1994.

Pagana, Kathleen D., and Timothy J. Pagana. Diagnostic Testing and Nursing Implications. 5th ed. St. Louis: Mosby, 1999.

PERIODICALS

Diette, G. B., N. Lechtzin, E. Haponik, A. Devrotes, and H. R. Rubin. "Distraction Therapy with Nature Sights and Sounds Reduces Pain during Flexible Bronchoscopy: A Complementary Approach to Routine Analgesia." Chest 123 (March 2003): 941–948.

Nakamura, C. T., J. F. Ripka, K. McVeigh, N. Kapoor, and T. G. Keens. "Bronchoscopic Instillation of Surfactant in Acute Respiratory Distress Syndrome." Pediatric Pulmonology 31, no. 4 (April 2001): 317–320.

Starobin, D., G. Fink, D. Shitrit, G. Izbicki, D. Bendayan, I. Bakal, and M. R. Kramer. "The Role of Fiberoptic Bronchoscopy Evaluating Transplant Recipients with Suspected Pulmonary Infections: Analysis of 168 Cases in a Multi-organ Transplantation Center." Transplantation Proceedings 35 (March 2003): 659–660.

Wu, K. H., T. T. Man, K. L. Wong, C. F. Lin, C. C. Chen, and C. R. Cheng. "Bronchoscopy and Anesthesia for Preschool-aged Patients: A Review of 228 Cases." Internal Surgery 87 (October-December 2002): 252–255.

Yang, C. C., and K. S. Lee. "Comparison of Direct Vision and Video Imaging during Bronchoscopy for Pediatric Airway Foreign Bodies." Ear, Nose, and Throat Journal 82 (February 2003): 129–133.

ORGANIZATIONS

American College of Chest Physicians. 3300 Dundee Road, Northbrook, IL 60062. (800) 343-2227.

The Association of Perioperative Registered Nurses, Inc. (AORN). 2170 South Parker Rd, Suite 300, Denver, CO 80231-5711. (800) 755-2676. <http://www.aorn.org/>.

OTHER

"Bronchoscopy." Medline Plus. [cited April 2003]. <http://www.nlm.nih.gov/medlineplus/ency/article/003857.htm>.

Public Health Advisory: Infections from Endoscopes Inadequately Reprocessed by an Automated Endoscope Reprocessing System. U. S. Food and Drug Administration, Center for Devices and Radiological Health. September 1999 [cited April 2003]. <http://www.fda.gov/cdrh/safety/endoreprocess.html>.

Maggie Boleyn, RN, BSN Monique Laberge, Ph D

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?

The test is usually performed in a hospital or clinic by a pulmonologist, a physician specializing in diseases of the lungs. Nursing staff assist by providing education, monitoring the patient, and conducting tests, including checking blood pressure, pulse, and respiratory rate prior to the patient's discharge.

QUESTIONS TO ASK THE DOCTOR

• What will happen during the procedure?
• Will it hurt?
• How long will the test last?
• How many bronchoscopies do you perform each year?
• Are there any risks associated with the procedure?