Safety of investigative bronchoscopy in the Severe Asthma Research Program

Wendy C. Moore, Michael D. Evans, Eugene R. Bleecker, William W. Busse, William Calhoun, Mario Castro, Kian Fan Chung, Serpil C. Erzurum, Douglas Curran-Everett, Raed A. Dweik, Benjamin Gaston, Mark Hew, Elliot Israel, Martin L. Mayse, Rodolfo M. Pascual, Stephen P. Peters, Lori Silveira, Sally E. Wenzel, Nizar N. Jarjour

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background: Investigative bronchoscopy was performed in a subset of participants in the Severe Asthma Research Program to gain insights into the pathobiology of severe disease. We evaluated the safety aspects of this procedure in this cohort with specific focus on patients with severe asthma. Objective: To evaluate prospectively changes in lung function and the frequency of adverse events related to investigative bronchoscopy. Methods: Bronchoscopy was performed by using a common manual of procedures. A subset of very severe asthma was defined by severe airflow obstruction, chronic oral corticosteroid use, and recent asthma exacerbations. Subjects were monitored for changes in lung function and contacted by telephone for 3 days after the procedure. Results: A total of 436 subjects underwent bronchoscopy (97 normal, 196 not severe, 102 severe, and 41 very severe asthma). Nine subjects were evaluated in hospital settings after bronchoscopy; 7 of these were respiratory-related events. Recent emergency department visits, chronic oral corticosteroid use, and a history of pneumonia were more frequent in subjects who had asthma exacerbations after bronchoscopy. The fall in FEV1 after bronchoscopy was similar in the severe and milder asthma groups. Prebronchodilator FEV 1 was the strongest predictor of change in FEV1 after bronchoscopy with larger decreases observed in subjects with better lung function. Conclusion: Bronchoscopy in subjects with severe asthma was well tolerated. Asthma exacerbations were rare, and reduction in pulmonary function after the procedure was similar to that in subjects with less severe asthma. With proper precautions, investigative bronchoscopy can be performed safely in severe asthma.

Original languageEnglish (US)
JournalJournal of Allergy and Clinical Immunology
Volume128
Issue number2
DOIs
StatePublished - Aug 2011
Externally publishedYes

Fingerprint

Bronchoscopy
Asthma
Safety
Research
Lung
Adrenal Cortex Hormones
Telephone
Chronic Obstructive Pulmonary Disease
Hospital Emergency Service
Pneumonia

Keywords

  • exacerbation
  • Investigative bronchoscopy
  • safety
  • severe asthma

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Safety of investigative bronchoscopy in the Severe Asthma Research Program. / Moore, Wendy C.; Evans, Michael D.; Bleecker, Eugene R.; Busse, William W.; Calhoun, William; Castro, Mario; Chung, Kian Fan; Erzurum, Serpil C.; Curran-Everett, Douglas; Dweik, Raed A.; Gaston, Benjamin; Hew, Mark; Israel, Elliot; Mayse, Martin L.; Pascual, Rodolfo M.; Peters, Stephen P.; Silveira, Lori; Wenzel, Sally E.; Jarjour, Nizar N.

In: Journal of Allergy and Clinical Immunology, Vol. 128, No. 2, 08.2011.

Research output: Contribution to journalArticle

Moore, WC, Evans, MD, Bleecker, ER, Busse, WW, Calhoun, W, Castro, M, Chung, KF, Erzurum, SC, Curran-Everett, D, Dweik, RA, Gaston, B, Hew, M, Israel, E, Mayse, ML, Pascual, RM, Peters, SP, Silveira, L, Wenzel, SE & Jarjour, NN 2011, 'Safety of investigative bronchoscopy in the Severe Asthma Research Program', Journal of Allergy and Clinical Immunology, vol. 128, no. 2. https://doi.org/10.1016/j.jaci.2011.02.042
Moore, Wendy C. ; Evans, Michael D. ; Bleecker, Eugene R. ; Busse, William W. ; Calhoun, William ; Castro, Mario ; Chung, Kian Fan ; Erzurum, Serpil C. ; Curran-Everett, Douglas ; Dweik, Raed A. ; Gaston, Benjamin ; Hew, Mark ; Israel, Elliot ; Mayse, Martin L. ; Pascual, Rodolfo M. ; Peters, Stephen P. ; Silveira, Lori ; Wenzel, Sally E. ; Jarjour, Nizar N. / Safety of investigative bronchoscopy in the Severe Asthma Research Program. In: Journal of Allergy and Clinical Immunology. 2011 ; Vol. 128, No. 2.
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abstract = "Background: Investigative bronchoscopy was performed in a subset of participants in the Severe Asthma Research Program to gain insights into the pathobiology of severe disease. We evaluated the safety aspects of this procedure in this cohort with specific focus on patients with severe asthma. Objective: To evaluate prospectively changes in lung function and the frequency of adverse events related to investigative bronchoscopy. Methods: Bronchoscopy was performed by using a common manual of procedures. A subset of very severe asthma was defined by severe airflow obstruction, chronic oral corticosteroid use, and recent asthma exacerbations. Subjects were monitored for changes in lung function and contacted by telephone for 3 days after the procedure. Results: A total of 436 subjects underwent bronchoscopy (97 normal, 196 not severe, 102 severe, and 41 very severe asthma). Nine subjects were evaluated in hospital settings after bronchoscopy; 7 of these were respiratory-related events. Recent emergency department visits, chronic oral corticosteroid use, and a history of pneumonia were more frequent in subjects who had asthma exacerbations after bronchoscopy. The fall in FEV1 after bronchoscopy was similar in the severe and milder asthma groups. Prebronchodilator FEV 1 was the strongest predictor of change in FEV1 after bronchoscopy with larger decreases observed in subjects with better lung function. Conclusion: Bronchoscopy in subjects with severe asthma was well tolerated. Asthma exacerbations were rare, and reduction in pulmonary function after the procedure was similar to that in subjects with less severe asthma. With proper precautions, investigative bronchoscopy can be performed safely in severe asthma.",
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AU - Evans, Michael D.

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AU - Busse, William W.

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AU - Castro, Mario

AU - Chung, Kian Fan

AU - Erzurum, Serpil C.

AU - Curran-Everett, Douglas

AU - Dweik, Raed A.

AU - Gaston, Benjamin

AU - Hew, Mark

AU - Israel, Elliot

AU - Mayse, Martin L.

AU - Pascual, Rodolfo M.

AU - Peters, Stephen P.

AU - Silveira, Lori

AU - Wenzel, Sally E.

AU - Jarjour, Nizar N.

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N2 - Background: Investigative bronchoscopy was performed in a subset of participants in the Severe Asthma Research Program to gain insights into the pathobiology of severe disease. We evaluated the safety aspects of this procedure in this cohort with specific focus on patients with severe asthma. Objective: To evaluate prospectively changes in lung function and the frequency of adverse events related to investigative bronchoscopy. Methods: Bronchoscopy was performed by using a common manual of procedures. A subset of very severe asthma was defined by severe airflow obstruction, chronic oral corticosteroid use, and recent asthma exacerbations. Subjects were monitored for changes in lung function and contacted by telephone for 3 days after the procedure. Results: A total of 436 subjects underwent bronchoscopy (97 normal, 196 not severe, 102 severe, and 41 very severe asthma). Nine subjects were evaluated in hospital settings after bronchoscopy; 7 of these were respiratory-related events. Recent emergency department visits, chronic oral corticosteroid use, and a history of pneumonia were more frequent in subjects who had asthma exacerbations after bronchoscopy. The fall in FEV1 after bronchoscopy was similar in the severe and milder asthma groups. Prebronchodilator FEV 1 was the strongest predictor of change in FEV1 after bronchoscopy with larger decreases observed in subjects with better lung function. Conclusion: Bronchoscopy in subjects with severe asthma was well tolerated. Asthma exacerbations were rare, and reduction in pulmonary function after the procedure was similar to that in subjects with less severe asthma. With proper precautions, investigative bronchoscopy can be performed safely in severe asthma.

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