Pulmonary & Critical Care

A bronchoscope is a device used to see the inside of the lungs. It can be flexible or rigid. Usually, a flexible bronchoscope is used. The flexible bronchoscope is a tube less than 1/2 inch wide and about 2 feet long.

How the Test Will Feel
Local anesthesia is used to relax the throat muscles. Until the anesthetic begins to work, you may feel fluid running down the back of your throat and have the need to cough or gag.

Once the anesthetic takes effect, you may have sensations of pressure or mild tugging as the tube moves through the windpipe (trachea). Although many patients feel like they might suffocate when the tube is in the throat, there is NO risk of suffocation. If you cough during the test, you will get more anesthetic.

When the anesthetic wears off, your throat may be scratchy for several days. After the test, the cough reflex will return in 1 – 2 hours. You will not be allowed to eat or drink until your cough reflex returns.

You may have a bronchoscopy to help your doctor diagnose lung problems. Your doctor will be able to inspect the airways or take a biopsy sample.

Common reasons to perform a bronchoscopy are:

• Abnormal finidngs on an x-ray or other imaging test
• Suspected interstitial lung disease
• Coughing up blood (hemoptysis)
• Possible foreign object in the airway
• Cough that has lasted more than 3 months without any other explanation
• Infections in the lungs and bronchi

You may also have a bronchoscopy to treat a lung or airway problem, such as:

• Remove fluid or mucus plugs from your airways
• Remove a foreign object from your airways
• Widen (dilate) an airway that is blocked or narrowed
• Drain an abscess
• Treat cancer using a number of different techniques
• Wash out an airway (therapeutic lavage)

How the Test is Performed
The scope is passed through your mouth or nose, through your windpipe (trachea), and then into your lungs. Going through the nose is a good way to look at the upper airways. The mouth method allows the doctor to use a larger bronchoscope.

A rigid bronchoscope requires general anesthesia. You will be asleep.

If a flexible bronchoscope is used, you will be awake. The doctor will spray a numbing drug (anesthetic) in your mouth and throat. This will cause coughing at first, which will stop as the anesthetic begins to work. When the area feels thick, it is numb enough. You may get medications through a vein (intravenously) to help you relax.

If the bronchoscopy is done through the nose, numbing jelly will be placed into one nostril.

Once you are numb, the tube will be inserted into the lungs. The doctor may send saline solution through the tube. This washes the lungs and allows the doctor to collect samples of lung cells, fluids, and other materials inside the air sacs. This part of the procedure is called a lavage.

Sometimes, tiny brushes, needles, or forceps may be passed through the bronchoscope and used to take tissue samples (biopsies) from your lungs. The pieces of lung material that are removed are small. The doctor can also place a stent in the airway or view the lungs with ultrasound during a bronchoscopy.

How to Prepare for the Test
Do not eat or drink anything 6 – 12 hours before the test. Your doctor may also want you to avoid any aspirin, plavix, or other blood-thinning drugs before the procedure.

You may be sleepy after the test, so you should arrange for transportation to and from the hospital.

Many people want to rest the following day, so make arrangements for work, child care, or other obligations. Usually, the test is done as an outpatient procedure, and you will go home the same day. Some patients may need to stay overnight in the hospital.

How the Test Will Feel
Local anesthesia is used to relax the throat muscles. Until the anesthetic begins to work, you may feel fluid running down the back of your throat and have the need to cough or gag.

Once the anesthetic takes effect, you may have sensations of pressure or mild tugging as the tube moves through the windpipe (trachea). Although many patients feel like they might suffocate when the tube is in the throat, there is NO risk of suffocation. If you cough during the test, you will get more anesthetic.

When the anesthetic wears off, your throat may be scratchy for several days. After the test, the cough reflex will return in 1 – 2 hours. You will not be allowed to eat or drink until your cough reflex returns.

• Bleeding from biopsy sites
• Infection

There is also a small risk of:

• Arrhythmias
• Breathing difficulties
• Fever
• Heart attack
• Low blood oxygen
• Pneumothorax
• Sore throat