Therapeutic Bronchoscopy revolutionising pulmonary medicine

Every breathing trouble or wheezing can’t be associated with asthma. Understanding the pulmonary disorders or pseudo-asthma is pivotal. Therapeutic Bronchoscopy helps diagnose and treat non-asthmatic breathing problems. It is a close relationship with pulmonary diseases and clinical allergy since occasional patients require such diagnoses to treat effectively.

Procedure
The diagnostic procedure is performed with the flexible fibre optic instrument and is undertaken to utilise topical anaesthesia. Light intravenous sedation is a usual adjunct; it’s preferable to use sedation for such procedures. Once the bronchoscope is in the airway, an additional topical anaesthetic will be sprayed into the airway for local anaesthesia to minimise discomfort and coughing spells.

The procedure requires continuous monitoring with a trained assistant for the patient as well as for specimen collection. The device is portable and can conveniently move around the bedside in an ICU or emergency ward if required. The instrument is introduced into the patient via nasal, oral or tracheostomy routes as per the operator.

“Diagnoses for therapeutic bronchoscopy is practised for the conditions like a persistent cough, blood in the sputum, abnormal chest x-ray such as mass, or inflammation in the lung and evaluation of a possible lung infection. Pulmonary physicians perform therapeutic bronchoscopy in order to remove foreign bodies from the airways, stricture dilation, control of haemorrhage, or laser resections,” says Dr Vinay Kumar, Chest Physician, Surya Chest Hospital.

Precautions
Patients undergoing such procedures should consume anything after midnight prior to the therapeutic. Routine medicines as prescribed should be taken with sips of water except for the drugs which minimize the risk of bleeding. These medications are aspirin products, blood thinners such as warfarin (Coumadin), and non-steroidal anti-inflammatory products such as ibuprofen.

(These drugs must be discontinued at varying numbers of days before the procedure, depending on the medication. Patients must consult their doctors for the appropriate schedule in their particular situation.) The doctor will also want to know of any drug allergies or major drug reactions that the patient may have experienced.

After the procedure
Patients are kept under observation for at least one to two hours to monitor the functioning of the swallowing easily and safely. The patient is advised to not involve in any activity like driving or operating heavy machinery for the rest of the day or several days as the reflexes and judgment may be impaired. Some patients may cough up dark-brown blood for the next one to two days after the procedure.

This is expected don’t get panic or restless. However, if there is persistent bright red blood in the sputum, the doctor must be consulted immediately. A follow-up visit with the doctor is scheduled to review the laboratory results, which are typically available within one week.

Complications and Risks
There are specific risks associated with both the procedures as well as the drugs used. The risk of bronchoscopy is limited while the complications from fiber-optic remain low. The most common complications include excessive bleeding following biopsy. A lung biopsy also may cause leakage of air, called pneumothorax. Pneumothorax occurs in less than 1 per cent of lung biopsy cases.

Laryngospasm is a rare complication but may sometimes require tracheal intubation. Patients with tumours or significant bleeding may experience increased difficulty breathing after a bronchoscopic procedure, sometimes due to swelling of the mucous membranes of the airways.

With advanced technology and revolutionizing medical practices are shaped to create a healthy environment for patients dealing with pulmonary diseases. Therapeutic bronchoscopy is one of the advanced technology in the medical field to cure let the people breathe a sigh of relief.