Bronchofiberscopy in Asthmatics: a Method for Minimizing Risk of Complications

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Abstract
Reasoning from known effects of salbutamol on the bronchial smooth muscle cell and their enhancement in asthmatics through steroids, this communication proposes a method employing these substances in such a way as to prevent bronchospasm during fiberoptic bronchoscopy. Following split-dosage administration of 100 mg prednisolone prior to bronchoscopy, a total of 3.75 mg salbutamol in a diluted saline solution is instilled intrabronchially through the biopsy channel. Transnasal fiberoptic bronchoscopy incorporation this method was performed in 15 asthmatics with neither laryngospasm nor bronchospasm being observed. In fact, comparison of FEV1 and FVC rates before and after bronchofiberscopy showed increases of 17% (t = 6.5513, p < 0.0005) and 12% (t = 5.2718, p < 0.0005), respectively. In a control group of 17 chronic bronchitics showing an improvement of 15% in flow rates after bronchodilators, no significant change was seen in FEV1 and FVC following fiberbronchoscopy. This procedure not only renders the diagnostic bronchofiberscopy relatively safe in asthmatics, but may be of use within the context of intensive care in serious bronchospasm refractive to conventional therapy.

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