Bronchoscopy

Question

Hello,

My daughter is 19 years old and for 5 years she has one infect exacerbation after the other. Currently, we have like 4-6 IV therapies per year. During the last treatment stay in Tannheim [place in Germany] a patient told my daughter about bronchoscopy. During the bronchoscopy of this girl, a lavage of the lung was made and the antibiotics reached the concerned areas directly which caused an improvement in her case. Now, I found an information in the internet where a patient also writes about bronchoscopy on a regular basis. However, the medical doctor of our ambulance did not give us the information we needed.

Does bronchoscopy make sense? When should it be made and what are the risks and what else has to be considered?
Please help us because it cannot go on like this.

Best regards,
U.

Answer

Hello,

First of all let me explain the possible benefits and risks of bronchoscopy. Bronchoscopy is a technique of visualizing the inside of the airways. Usually, a local anaesthesia is made (in some hospitals it is done under general anaesthesia); then a flexible tube is inserted via one nostril or the mouth into the airway or the bronchial system. The image is transferred to a screen so that one can get an impression of the existing abnormalities. In the course of a bronchoscopy, several examinations can be done. The lavage that you mentioned is probably the so called bronchoalveolar lavage where cells are taken from the alveolar region. This is done by flushing solution of sodium chloride into the airways and withdraw it by suction. This examination technique is well suited for diagnosing pathogens. In case of permanent infection which require IV therapies again and again the bronchoscopy can also be considered.
The risks of a bronchoscopy are low. In addition to cough and hoarseness, the oxygen saturation might decrease slightly and fever might occur.
If samples of the bronchial mucous membrane of even of the lung tissue are taken, there is the rare risk of developing a lung collapse.
You also mentioned that a girl received antibiotics through the bronchoscopy tube.
An antibiotic therapy in the course of a bronchoscopy is surely not established and the use of such a therapy should be questioned.
A specific antibiotic therapy with tablets or given IV after having diagnosed the pathogens in the course of an bronchoalveolar lavage is, however, an important possible part of diagnostics of pulmonary diseases.

Best regards,
Dr. med. W. Gleiber

14.10.2009