Immediate spirometric alterations after bronchoscopy in diffuse lung disease

To evaluate the spirometric alterations after bronchoscopy with bronchoalveolar lavage (BAL) and bronchoscopic lung biopsy in patients with diffuse lung disease (DLD).

Twenty-three patients with DLD and 6 individuals with solitary pulmonology nodule or dyspnea were subjected to BAL with the infusion of 4 aliquots of 50 mL of saline solution at room temperature; 3 to 5 bronchoscopic lung biopsy specimens were obtained from the locations based on chest x-ray and/or tomogram findings. Spirometry was perfomed before and 10, 30, and 60 minutes after the bronchoscopic procedure.

A meaningful spirometric decrease within the group with DLD and in the control group was observed, being more intense 10 minutes after the completion of the examination, followed by a natural tendency of returning to initial baseline values after 60 minutes. The DLD group presented a more significant decrease (P<0.05) in: forced vital capacity 14.4%, forced expiratory volume in the first second 12.7%, peak expiratory flow rate 15.9%, forced expiratory flow at 50% volume 13.6%, and peripheral saturation of oxygen 3.6%. Despite the decrease in the spirometry, the group with DLD presented only minor complications, such as transitory hypoxemia and bleeding.

Our results suggest that bronchoscopy associated with BAL and bronchoscopic lung biopsy is a safe procedure in patients with restrictive lung diseases, despite a decrease in their spirometric values.