Increased hypoxemia in patients with COPD and pulmonary hypertension undergoing bronchoscopy with biopsy
Yoram Neuman,1,3 Matthew Koslow,2,3 Alona Matveychuk,2,3 Avigdor Bar-Sef,1 Alexander Guber,2,3 David Shitrit2,3 1Division of Cardiology, 2Pulmonary Department, Meir Medical Center, Kfar Saba, Israel; 3Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Background and objective: Pati...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2015-12-01
|
| Series: | International Journal of COPD |
| Subjects: | |
| Online Access: | https://www.dovepress.com/increased-hypoxemia-in-patients-with-copd-and-pulmonary-hypertension-u-peer-reviewed-article-COPD |
| _version_ | 1811215431450492928 |
|---|---|
| author | Neuman Y Koslow M Matveychuk A Bar-Sef A Guber A Shitrit D |
| author_facet | Neuman Y Koslow M Matveychuk A Bar-Sef A Guber A Shitrit D |
| author_sort | Neuman Y |
| collection | DOAJ |
| description | Yoram Neuman,1,3 Matthew Koslow,2,3 Alona Matveychuk,2,3 Avigdor Bar-Sef,1 Alexander Guber,2,3 David Shitrit2,3 1Division of Cardiology, 2Pulmonary Department, Meir Medical Center, Kfar Saba, Israel; 3Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Background and objective: Patients with pulmonary hypertension (PH) are considered to be at risk for complications associated with flexible bronchoscopy (FB), but data concerning the degree of PH are often lacking. We investigated whether COPD patients with PH who undergo bronchoscopy are at greater risk for complications. Methods: This prospective study included 207 consecutive COPD patients undergoing FB. All underwent an echo-Doppler to evaluate pulmonary artery pressure on the day of the bronchoscopy procedure. Pulmonologists were blinded to the echocardiogram results. Results: A total of 167 patients (80.7%) had normal pulmonary pressure. The remaining 40 patients (19.3%) had PH: 27 (13.0%) mild, eight (3.9%) moderate, and five (2.4%) severe. Noninvasive hemodynamic parameters between groups before and after FB were similar. Two patients with normal pulmonary pressure developed supraventricular tachycardia. None developed hemodynamically significant dysrhythmia. Bleeding episodes between groups in bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB) did not differ. PH patients who underwent BAL and TBB had decreased O2 saturation during the procedure compared with the non-PH group (23.5% vs 6.9%, P=0.033). No deaths were attributable to FB. Conclusion: PH is common among COPD patients undergoing FB. PH patients undergoing BAL and TBB are at higher risk of decreased O2 saturation than those without PH. Further studies should assess the risk among COPD patients with moderate-to-severe PH. Keywords: bronchoscopy, hypoxemia, pulmonary hypertension |
| first_indexed | 2024-04-12T06:22:31Z |
| format | Article |
| id | doaj.art-51d086c285c9479fa86929f7979616d0 |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-04-12T06:22:31Z |
| publishDate | 2015-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-51d086c285c9479fa86929f7979616d02022-12-22T03:44:16ZengDove Medical PressInternational Journal of COPD1178-20052015-12-012015Issue 12627263224885Increased hypoxemia in patients with COPD and pulmonary hypertension undergoing bronchoscopy with biopsyNeuman YKoslow MMatveychuk ABar-Sef AGuber AShitrit DYoram Neuman,1,3 Matthew Koslow,2,3 Alona Matveychuk,2,3 Avigdor Bar-Sef,1 Alexander Guber,2,3 David Shitrit2,3 1Division of Cardiology, 2Pulmonary Department, Meir Medical Center, Kfar Saba, Israel; 3Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Background and objective: Patients with pulmonary hypertension (PH) are considered to be at risk for complications associated with flexible bronchoscopy (FB), but data concerning the degree of PH are often lacking. We investigated whether COPD patients with PH who undergo bronchoscopy are at greater risk for complications. Methods: This prospective study included 207 consecutive COPD patients undergoing FB. All underwent an echo-Doppler to evaluate pulmonary artery pressure on the day of the bronchoscopy procedure. Pulmonologists were blinded to the echocardiogram results. Results: A total of 167 patients (80.7%) had normal pulmonary pressure. The remaining 40 patients (19.3%) had PH: 27 (13.0%) mild, eight (3.9%) moderate, and five (2.4%) severe. Noninvasive hemodynamic parameters between groups before and after FB were similar. Two patients with normal pulmonary pressure developed supraventricular tachycardia. None developed hemodynamically significant dysrhythmia. Bleeding episodes between groups in bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB) did not differ. PH patients who underwent BAL and TBB had decreased O2 saturation during the procedure compared with the non-PH group (23.5% vs 6.9%, P=0.033). No deaths were attributable to FB. Conclusion: PH is common among COPD patients undergoing FB. PH patients undergoing BAL and TBB are at higher risk of decreased O2 saturation than those without PH. Further studies should assess the risk among COPD patients with moderate-to-severe PH. Keywords: bronchoscopy, hypoxemia, pulmonary hypertensionhttps://www.dovepress.com/increased-hypoxemia-in-patients-with-copd-and-pulmonary-hypertension-u-peer-reviewed-article-COPDBronchoscopy/bronchushypoxia/reoxygenationpulmonary vascular resistance/hypertension |
| spellingShingle | Neuman Y Koslow M Matveychuk A Bar-Sef A Guber A Shitrit D Increased hypoxemia in patients with COPD and pulmonary hypertension undergoing bronchoscopy with biopsy International Journal of COPD Bronchoscopy/bronchus hypoxia/reoxygenation pulmonary vascular resistance/hypertension |
| title | Increased hypoxemia in patients with COPD and pulmonary hypertension undergoing bronchoscopy with biopsy |
| title_full | Increased hypoxemia in patients with COPD and pulmonary hypertension undergoing bronchoscopy with biopsy |
| title_fullStr | Increased hypoxemia in patients with COPD and pulmonary hypertension undergoing bronchoscopy with biopsy |
| title_full_unstemmed | Increased hypoxemia in patients with COPD and pulmonary hypertension undergoing bronchoscopy with biopsy |
| title_short | Increased hypoxemia in patients with COPD and pulmonary hypertension undergoing bronchoscopy with biopsy |
| title_sort | increased hypoxemia in patients with copd and pulmonary hypertension undergoing bronchoscopy with biopsy |
| topic | Bronchoscopy/bronchus hypoxia/reoxygenation pulmonary vascular resistance/hypertension |
| url | https://www.dovepress.com/increased-hypoxemia-in-patients-with-copd-and-pulmonary-hypertension-u-peer-reviewed-article-COPD |
| work_keys_str_mv | AT neumany increasedhypoxemiainpatientswithcopdandpulmonaryhypertensionundergoingbronchoscopywithbiopsy AT koslowm increasedhypoxemiainpatientswithcopdandpulmonaryhypertensionundergoingbronchoscopywithbiopsy AT matveychuka increasedhypoxemiainpatientswithcopdandpulmonaryhypertensionundergoingbronchoscopywithbiopsy AT barsefa increasedhypoxemiainpatientswithcopdandpulmonaryhypertensionundergoingbronchoscopywithbiopsy AT gubera increasedhypoxemiainpatientswithcopdandpulmonaryhypertensionundergoingbronchoscopywithbiopsy AT shitritd increasedhypoxemiainpatientswithcopdandpulmonaryhypertensionundergoingbronchoscopywithbiopsy |