A randomized, placebo-controlled trial of bronchodilators for bronchoscopy in patients with COPD
Department of Pulmonary, Allergy and Critical Care Medicine
Administration, Inhalation; Adult; Aged; Aged, 80 and over; Albuterol; Bronchodilator Agents; *Bronchoscopy; Double-Blind Method; Female; Forced Expiratory Volume; Humans; Male; Middle Aged; Premedication; Pulmonary Disease, Chronic Obstructive; Statistics as Topic; Vital Capacity
Life Sciences | Medicine and Health Sciences
BACKGROUND: In contrast to asthma, the indication for bronchodilators prior to bronchoscopy in patients with COPD has not been properly investigated. We therefore performed a randomized, double-blind, placebo-controlled trial to determine whether use of a short-acting bronchodilator provides a protective effect in patients with COPD undergoing bronchoscopy. METHODS: One hundred twenty patients undergoing bronchoscopy were included. Patients with COPD were randomized to receive either 200 mug of salbutamol (n = 40) or placebo (n = 40) before bronchoscopy. Control patients (n = 40) did not receive any inhaled medication. Spirometry was performed before and 2 h after bronchoscopy in all patients. Sedative drug requirements and hemodynamic parameters were recorded. RESULTS: Hemodynamic findings before, during, and after bronchoscopy were similar in patients with COPD randomized to either salbutamol or placebo (p = not significant for all). Compared to prebronchoscopy values, postbronchoscopy percentage of predicted FEV(1) decreased significantly in all three groups: salbutamol (median, - 4.7%; interquartile range [IQR], - 13.3 to 6.6); placebo (median, - 4.8%; IQR, - 19.9 to 8.4); and control subjects (median, - 10.0%; IQR, - 20.2 to - 3.3) [p = 0.023]. The decrease in FEV(1) was similar in all three patient groups (p = 0.432). The relative change in FEV(1) was inversely correlated to the increasing severity of COPD as expressed by Global Initiative for Chronic Obstructive Lung Disease stages (p = 0.01). CONCLUSIONS: Premedication with an inhaled short-acting beta-agonist cannot be recommended in patients with COPD undergoing bronchoscopy.
DOI of Published Version
Chest. 2007 Mar;131(3):765-72. Link to article on publisher's site
Stolz D, Pollak V, Chhajed PN, Gysin C, Pflimlin E, Tamm M. (2007). A randomized, placebo-controlled trial of bronchodilators for bronchoscopy in patients with COPD. Open Access Publications by UMMS Authors. https://doi.org/10.1378/chest.06-2308. Retrieved from https://escholarship.umassmed.edu/oapubs/1248