What is the Bronchoscopy | Medical tests

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Medical test used to diagnose and treat diseases of the respiratory tract and lungs.

Bronchoscopy

Bronchoscopy, also known as fibrobroncoscopia, is a medical test used to diagnose and treat diseases of the respiratory tract and lungs. Through a bronchoscope, a device that consists of a tube of about of half a centimeter in diameter and variable length, depending on the age of the patient, who has a video camera on its end. Lets you see clearly inside the Airways on a monitor. The bronchoscope tube also has several channels in its interior, where you can enter various instruments, and allow diagnostic testing such as the taking of biopsies, or even perform treatments such as Cauterization of bleeding vessels or the removal of polyps.

Types of bronchoscopes

There are two types of bronchoscopes. The flexible bronchoscope is used more frequently. It consists of a thin, flexible tube that is inserted through the nose and allows you to get very far in the airway with greater comfort for the patient. General anesthesia for use is not required. The rigid bronchoscope is a thick, short and rigid tube. It is inserted through the mouth and may not get as far as the flexible bronchoscope. Their use requires that the patient is under general anesthesia. The advantage of the rigid bronchoscope is that its light is very thick. Used in cases of massive bleeding which can prevent a correct visibility with the flexible bronchoscope. It is also used to perform biopsies of large size or to remove large foreign bodies that could not be removed with the flexible bronchoscope. There are procedures such as dilation of a bronchus which has narrowed, or the use of the laser to destroy a tumor, which are carried out by means of the rigid bronchoscope.

Bronchoscopy is done

The most common reasons why this test may be requested are as follows:
  • Identify the cause of some symptoms such as chronic cough, bleeding (hemoptysis) cough or difficulty breathing.
  • Take biopsies of the Airways of the lung or lymph nodes near, or samples to study possible respiratory infections, tumors, or other lung diseases.
  • Diagnose and evaluate the extent of lung cancer.
  • Remove foreign bodies in the airway.
  • Treat bleeding that occurs in the Airways.
  • Expand areas of the respiratory tract have been able to narrow by a tumor or other diseases. It allows the placement of a stent, which is like a spring self-expanding, which widens the strictured area and keeps it open.
  • Treat cancer of the lung by means of the laser or by placing radioactive substances (brachytherapy)

Preparation for Bronchoscopy

These are the issues that you must take into account in preparation prior to submit to a Bronchoscopy:
Duration: the test is performed in about 30 minutes, but it can take longer depending on the findings, which are, or if any therapeutic procedure is done or take biopsies.
Entry: most common, i.e. flexible Bronchoscopy bronchoscopy, can be done on an outpatient basis. Rigid Bronchoscopy requires general anesthesia and may require income.
Is necessary to be accompanied?: is usually administer a sedative so stay quiet during the test, so it is recommended that someone accompany you to take you home then.
Drugs: is not required any special medication.
Food: is necessary to remain without ingesting water or food for 8-10 hours before the test.
Clothing: you can wear any clothes you want to but it should be easy to remove, as they will remove you most of the clothes and will facilitate you a hospital gown.
Documents: should be informed consent, which is a role where they explain you what is the test and its potential risks. You should read it carefully and take it signed. You must take the wheel of the test request.
Contraindications: You should not do a bronchoscopy in the following cases:
  • Serious or "unstable" patients with significant hypotension, severe arrhythmia, etc.
  • In patients with respiratory failure that will not tolerate the test. In these cases can sometimes be under general anesthesia and intubated in a unit of intensive surveillance (UVI)
  • Pregnancy is a relative contraindication.
  • Serious blood clotting problems.
Pregnancy and lactation: in general the test should be avoided during pregnancy, although on occasions it could be if it is considered that the benefits outweigh the risks. The minimum dose of sedatives is used possible and always with medications safe for the fetus. Breastfeeding in general is not a contraindication the test. Sedatives given to perform the procedure in general does not pose a risk to the infant, unless you have severe breathing problems.

Other considerations regarding the Bronchoscopy

You should tell the doctor if you have allergies to medications, particularly to anaesthetics.
If you are taking aspirin or NSAIDs may tell you to stop taking them the 7-14 days prior to the test. This is must be aspirin and anti-inflammatory drugs would facilitate the bleeding where necessary take a biopsy or remove a polyp. The doctor will instruct you when to resume this medication.
If you are taking anticoagulants, it is very important to warn the doctor, then it will be necessary to temporarily suspend them. The doctor will give you instructions in this sense depending on the anticoagulant that take.

Bronchoscopy is done

Bronchoscopy is often make a medical specialist in pneumology together with an Assistant who may be nursing staff. The most frequent is a flexible bronchoscope is used. Initially, they will tell you to undress from the waist up and put on a hospital gown. You will also need to remove dentures, sonotone, contact lenses, sunglasses, jewelry, etc, and not to wear make-up. It is a good idea to go to urinate before the test so that they do not enter a desire during the procedure.
It will pick up a vein in the arm. There you can pass a drug that will make you to be relaxed and drowsy during the test. It is possible to then not remember much about the procedure. They put electrodes to control the heart rate and the amount of oxygen in the blood during the test. They also checked her blood pressure. It is usually given an anesthetic in the nose and throat spray to lessen the discomfort and facilitate the introduction of the bronchoscope.
The test is usually performed sitting on a chair similar to the dentists. The physician shall introduce the bronchoscope previously lubricated by the nose, although sometimes you can enter through the mouth. It reaches the vocal cords, where more anesthetic spray is administered. It can the doctor tell you that you will pick strong air pipe pass vocal cords. It is important that you do not attempt to speak during the procedure. Then the doctor will examine the trachea and bronchi.
The doctor has tools such as microtweezers, capsula, etc. that you can get the channels that has the bronchoscope, and allow you to perform some diagnostic or therapeutic procedures. For example, can suck secretions, take a biopsy, removing a polyp coagulate bleeding, remove a body odd, etc. Occasionally can be used at the same time an x-ray machine, which will be located on top of you and allows you to take x-ray images that can be on a video screen. This helps the doctor to locate certain areas of the lung and to perform various procedures.
After all, the bronchoscope be taken off carefully, and you can let you 2-3 hours in observation in any room annexed until it recovers the sedative effect. As an anesthetic throat have applied you, it is necessary not to eat or drink until you pass the effect of anesthesia. Otherwise, it could be that the food was by the respiratory route. Spit saliva and don't swallow it until you notice that it has passed the anesthetic of the throat is also recommended. It is recommended that you do not drive or operate dangerous machinery during the 12 hours following the test. You should not smoke at least 24 hours. Your doctor will instruct you when you can eat normally and restart the regular activities. This depends on the procedure that have yet done you and medication which provided him.
Rigid Bronchoscopy He is performed under general anesthesia and lying. It does need to be intubated, i.e., that have a tube placed in the trachea to be able to breathe. This tube is connected to a machine that is that insufflates her air. It then proceeds to introduce the rigid endoscope and make sampling or therapeutic procedures.

Complications of Bronchoscopy

Bronchoscopy is a very safe test. It is also rare to have side effects from medications that can be given as sedatives. The anesthetic spray that will have in the throat knows something bitter and makes you feel tingling and swelling in the throat and tongue. You can notice chest tightness or have some gagging or coughing while moving the bronchoscope. The airway is not blocked during the test never, but if you notice any significant discomfort can be noted is the doctor giving him a small hit in the arm or with any previously agreed signal.
After the procedure you will feel drowsy for a few hours and is likely to not remember much of what happened. You may notice some discomfort in the throat for a few days. These nuisances can calm down if gargling with warm salt water. If you've had a biopsy or have had your a polyp removed you can cough with some blood for a few days.
It is very rare that there is a grave by a Bronchoscopy complication, although it can occur. In rare cases the procedure can cause cardiac arrhythmias or spasm of the bronchi, which may hinder breathing (as occurs in asthma). Sometimes, the bronchoscope can damage the surface of the mucosa and cause bleeding. If the lung is punctured you can enter air between the lung and the chest wall and cause a collapse of the lung, a complication called pneumothorax. There is a minimal risk of infection by the procedure. Exceptional cases of death due to the test have been described.
You have a few tenths after the race may be normal. However, if after the test Note chest pain, shortness of breath, fever higher than 38 ° C, severe dizziness, cough up an appreciable amount of blood, or have any other symptoms that worry you, should immediately contact their doctor.

Results of Bronchoscopy

During Bronchoscopy airway surface, is seen with what your doctor can diagnose many diseases directly. It is possible that later you any results the day of the test. The specialist will make a written report that will give you a few days of the test, possibly along with some photos of possible pathological as polyps, ulcers or tumours findings.
When biopsies have been taken, the samples will be studied under a microscope by a pathologist and a report will be made separately with this result.
You can also that you have caught samples for microbiological study of possible lung infections. This will result in a third report by a specialist in microbiology. All these results may take several weeks to be available.
Bronchoscopy result report it will include data on the tolerance test, territories explored with the bronchoscope, the medication that has been given him and possible eventualities that have occurred during the test. Describe the appearance of the airway and possible pathologies such as polyps, diverticula, tumors, ulcers, bleeding, inflammation, etc. Specify possible diagnostic or therapeutic procedures that have been made, like biopsies or removal of polyps, and to which lab extracted samples have been sent. The report will be completed in a few weeks with the results of these samples.
The doctor has asked the test will give you the results and will instruct you to need to make other complementary explorations or follow any treatment.
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