Bronchoscopy / Lung Biopsy
Bronchoscopy is a diagnostic procedure used to obtain a small amount of lung tissue and fluid samples (a lung biopsy).
- Bronchoscopy can help detect infections, tumors, and bleeding in the lungs
- For people who have undergone lung transplant, bronchoscopy is used to monitor organ rejection
- Complications from bronchoscopy are rare. The most common complication is bleeding from the biopsy site.
During a bronchoscopy, a lung doctor takes a small camera (a bronchoscope) attached to a thin tube and gently positions by passing the scope through the throat and into the bronchial tubes of the lungs. With the camera in place, the doctor can see inside the lungs on a video monitor and can look for conditions such as infection, tumors, bleeding and other abnormalities.
Special tools at the tip of the scope allow the doctor to collect a small sample of lung tissue that can be examined under a microscope for additional diagnostic information.
For people who have received a lung transplant, bronchoscopy and lung biopsies provide important information about the condition of transplanted lung(s) and can help diagnose rejection and change in lung function.
How do I prepare for a bronchoscopy?
People who are scheduled for a bronchoscopy should be aware of the following instructions and expectations:
- Abstain from aspirin and ibuprofen-containing medications before the procedure. This includes but is not limited to Advil, Motrin, Nuprin, and Aleve, as these medications can cause increased bleeding. Tylenol is OK. Notify your physician if you are taking blood thinning medication.
- Your doctor may order tests such as blood tests, an EKG, or a chest x-ray, to be performed before the procedure. These tests may be done in the physician's office, the hospital, or in an outside laboratory.
- On the night before the procedure, do not eat or drink anything after midnight, unless your doctor gives you different instructions.
- If you usually take medications in the morning, ask your doctor whether you should take them as usual or if they should be taken after the test.
- When you come for the procedure, bring a list of any medications you are taking, along with the dose of each medication.
- Dress comfortably and leave valuables at home.
- Be sure to arrange for someone who will be responsible for taking you home after testing.
Please note: If you have a heart murmur, heart valve problems or artificial joints, remind your doctor. You may need to take an antibiotic before the bronchoscopy as a precaution.
How is bronchoscopy performed?
- In the procedure room, your temperature, pulse, and blood pressure will be taken.
- A plastic clip will be placed on your finger to measure the oxygen in your blood during the procedure. This is known as a pulse oximeter.
- Your heart rate will be monitored throughout the test, and you will receive oxygen.
- An IV (an intravenous line, a thin plastic catheter which goes into your vein) will be started. This is used to give you medication as needed.
- Medication may be used to make you drowsy and relaxed.
- Your throat will be sprayed with a local anesthetic to make it numb. This will make you more comfortable when the scope is passed through the throat.
- The bronchoscope is a long soft tube with a magnifying glass and light on the end. The tube is about as wide as a pencil. The scope is gently passed through your nose or mouth, and into your lungs.
- You will be able to breathe easily throughout the procedure. The doctor will be able to see into the airways, and can take samples of tissue for biopsy through the scope. You will be observed closely by the nurse during the test and afterwards, until you are fully awake and able to leave the area for discharge.
How will I feel during bronchoscopy?
- You might feel some discomfort as the scope is passed through your nose and throat. This will be minimal and it will last only about 10-15 seconds.
- Usually there is a small amount of bleeding after the test if a biopsy is taken. You may notice that you cough up some blood tinged mucous. This will decrease after a few hours. If the bleeding increases or if it lasts longer than 24 hours, call your doctor.
What are the risks of a bronchoscopy?
- The primary risk with bronchoscopy is bleeding from the site of the biopsy, but this occurs in less than 1% of patients.
- Other rare complications include lung collapse, hoarseness, sore nose or throat.
You will be monitored closely for several hours after the procedure to make sure no complications arise.
When can I eat after bronchoscopy?
- Two hours after the test, you will be able to take a few sips of water.
- If you can swallow without a problem, you can eat and drink normally at that time. If not, wait another hour and then try sips of water again.
What should I do when I get home?
You may want to take it easy for the rest of the day after the test. If you received sedation you may feel tired or sleepy. Do not drive or operate machinery or sign any legal documents for the next 24 hours after the sedation.
- Do not take aspirin or medications such as ibuprofen in the first 24 hours after the procedure.
- Check the label of brand name medications to see if they contain ibuprofen or aspirin. These medications can increase bleeding.
- Check with your doctor about any possible changes in your usual medications and ask when you can begin to take them again.
- You may have a slight fever after the bronchoscopy and your doctor may suggest taking acetaminophen (for example Tylenol) for fever or discomfort.
What symptoms should I report to the doctor after bronchoscopy?
- Bleeding that lasts longer that 24 hours or if it increases (report amounts greater that blood-streaked mucus).
- Fever (temperature over 100F) that lasts more than 24 hours.
- Shortness of breath or chest pain.
- Coughing-up large amounts of blood
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