Bronchoscopy in Cystic Fibrosis
What is a bronchoscopy?
Bronchoscopy is a technique that allows doctors to look at the inside of the airways to help in diagnosing problems or for treatment. A camera called a bronchoscope is inserted into the airways, usually through the nose or mouth. This allows the doctor to see the airways and take photographs or videos.
Why do a bronchoscopy in a person with Cystic Fibrosis?
A bronchoscopy allows doctors to take a sample of mucous from deep in the airways. In CF the purpose of a bronchoscopy is to diagnose a specific bacterial infection and remove excess fluid and mucous that may be causing symptoms. Bronchoscopies are particularly helpful when a sputum sample is unable to be collected and symptoms (eg: moist cough, shortness of breath) persist despite treatment. The sample from the bronchoscopy is used to make sure the current treatment is the best option for the bacteria found.
Bronchoscopies can also be used to move mucous out of the lungs using a lung washing or broncho-alveolar lavage [BAL]. This is done by putting sodium chloride 0.9% (sterile saltwater) into the lungs and then suctioning it out along with the mucus. There is a small amount of sodium chloride 0.9% that is left in the lungs, but it will be quickly absorbed by the lungs.
What happens when you have a bronchoscopy?
A bronchoscopy is normally performed under mild sedation for adults, so you are awake but feel relaxed and drowsy during the procedure. For children the bronchoscopy is performed under a general anaesthetic. Both adults and children are required to fast for at least 6 hours prior to the scheduled time of their procedure. A local anaesthetic is given to reduce discomfort to the nose/throat, which is usually a spray or a gargle. The procedure usually takes about 20 minutes then you/your child will spend some time in recovery waiting for the anaesthetic and sedative to wear off. If you have CF and require a bronchoscopy, you will most likely stay in hospital overnight after the procedure for observation. You might have some mild throat irritation for a few days, but it should go away without further treatment.
Are bronchoscopies safe?
A bronchoscopy is a very safe procedure that is generally well tolerated, but as with any medical procedure there are some risks, namely, bleeding and infection. Most people cough a lot after waking up from the bronchoscopy, but this will usually settle quickly. A fever occurs commonly after bronchoscopy but this is not a cause for alarm and usually settles quickly, either on its own or after a dose of medication [e.g. paracetamol or ibuprofen]. If you have any questions not answered on this page, please feel free to discuss it with your CF doctor or contact the CF nurse coordinators on (03) 9594 2915 or monashcf@monashhealth.org.