From the Guidelines
Bronchoscopy can lead to several potential complications, including bleeding, infection, fever, and sore throat, with more serious complications such as pneumothorax, respiratory failure, and cardiac arrhythmias being relatively uncommon. The most frequent complications of bronchoscopy include:
- Bleeding, which can occur in up to 0.7% of patients, especially those undergoing transbronchial biopsies or with underlying bleeding disorders 1
- Infection, which is rare but can occur despite sterile technique, particularly in immunocompromised patients 1
- Respiratory complications, such as bronchospasm, laryngospasm, hypoxemia, or exacerbation of underlying lung disease, which can be managed with appropriate monitoring and emergency equipment 1
- Sedation-related complications, including hypotension, respiratory depression, and paradoxical reactions, which can be minimized with careful sedation management and monitoring 1 Other potential complications of bronchoscopy include:
- Pneumothorax, which is more common when transbronchial biopsies are performed 1
- Cardiac arrhythmias, which can occur in patients with underlying cardiac conditions 1
- Adverse reactions to sedation medications, which can be managed with careful sedation management and monitoring 1
- Rare but serious complications, such as air embolism, mediastinal emphysema, and death, which have a mortality rate of less than 0.1% 1 Patients with severe COPD, unstable cardiac conditions, or significant hypoxemia face higher risks of complications from bronchoscopy, and the procedure should be performed by experienced providers with appropriate monitoring and emergency equipment available 1.
From the Research
Potential Complications of Bronchoscopy
The potential complications of bronchoscopy can be categorized into mechanical and systemic complications.
- Mechanical complications are primarily related to airway manipulations or bleeding 2.
- Systemic complications arise from the procedure itself, medication administration (primarily sedation), or patient comorbidities 2.
Specific Complications
Some specific complications of bronchoscopy include:
- Bleeding, which can be catastrophic and result in fatal outcomes, especially in patients using antithrombotic agents 3, 4.
- Pneumothorax, a rare complication of bronchoscopy, which can occur even without biopsy 5.
- Hypoxemia, which is the most common complication during or immediately after the procedure, especially in critically ill patients 6.
- Bradycardia and hypotension, which can occur in some patients 6.
Risk Factors for Complications
Certain factors can increase the risk of complications during bronchoscopy, including: