Blood loss during flexible bronchoscopy: a prospective observational study

Area of Science:

• Pulmonology
• Gastroenterology
• Interventional Endoscopy

Background:

• Hemorrhage is a known complication of flexible bronchoscopy.
• Assessing actual blood loss is crucial for patient safety.

Purpose of the Study:

• To quantify blood loss in low-risk patients undergoing flexible bronchoscopy.
• To identify factors associated with bleeding, including pulmonary pathology, SVC syndrome, procedures, and lab values.

Main Methods:

• 234 patients were enrolled over 18 months, excluding those with bleeding risks.
• Blood loss was measured from aspirated secretions using a hemoglobin detector.
• Bleeding was categorized as minimal, mild, moderate, or severe.

Main Results:

• No severe bleeding occurred; most cases had minimal blood loss (<5 ml).
• Superior vena cava (SVC) syndrome was associated with higher mean blood loss (6.0 ml).
• Transbronchial needle aspiration (TBNA) alone resulted in less blood loss than when combined with biopsies.

Conclusions:

• Flexible bronchoscopy in preselected low-risk patients did not result in severe bleeding.
• Clinical screening and a platelet count ≥20 × 10(3)/µl appear sufficient for identifying low-risk individuals.