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Unlabelled: Bronchoscopy is a very useful tool in asthma research studies. The study was undertaken to evaluate the effect of bronchoscopy, BAL and bronchial biopsies on heart rate and arrhytmias in patients with asthma. Twenty patients (12 M, 8 F, mean age 39,6+/-16,3 yrs) with asthma (mean FEV, 81+/-19.5% pred.; mean FEV(1)%VC 69+/-12.3%) participated in the study. Holter ECG monitoring was performed twice: before (1 or 2 days) and on the day of bronchoscopy. Heart rate and cardiac arrhythmias were compared to prebronchoscopy recording at four separate time intervals: during bronchoscopy, first postbronchoscopic hour, second postbronchoscopic hour and total 24 hours. There were no significant differences between mean heart rate at the time of bronchoscopy (88.5+/-14.1 min(-1) vs 83.7+/-11.9 min(-1)), first and second postbronchoscopic hour (80.9+/-15.8 min(-1) vs 85.7+/-13.7 min(-1) and 82.6+/-13.6 min(-1) vs 80.6+/-11.6 min(-1)) as well as total 24 hours (76.1+/-11.2 min(-1) vs 75.9+/-9.4 min(-1)) as compared to prebronchoscopic recordings. Max. heart rate during bronchoscopy was higher as compared to the corresponding time of prebronchoscopic recording (134.5+/-11.5 min(-1) vs 122.5+/-19.6 min(-1), p<0,05). No differences in the number and type of ventricular (VA) and supraventricular arrhythmias (SVA) between the pre- and peribronchoscopic monitoring were observed. Positive correlation between the age and the number of VA during bronchoscopy has been found., Conclusion: Bronchoscopic procedures in asthma patients do not increase the risk of cardiac arrhythmias. Some factors influencing the heart rate and number of VA during bronchoscopy can be identified.

Unlabelled: Nitric oxide has been extensively studied as a noninvasive marker of airway inflammation, especially in asthma. Assuming, bronchoscopy can produced not only systemic but also local inflammatory response we hypothesized that bronchofiberoscopy can be responsible for an increase in nitric oxide synthesis with resulting increase in fractional concentration of exhaled nitric oxide (FE(NO)). Seventeen subjects (10 M, 7 F), at mean age of 53.8+/-14.1 yrs undergoing diagnostic bronchoscopy participated in the study. The indications for bronchoscopy were as follows: lung cancer (n=5; 29%), interstitial lung diseases (n=3; 18%), slowly resolving pneumonia (n=3; 18%), hemoptysis (n=3; 18%), differential diagnosis of asthma/ dyspnea (n=3; 18%). During bronchoscopy bronchial washing (n=7) and bronchoalveolar lavage (BAL) (n=10) has been performed. FE(NO) has been analyzed on-line with chemiluminescence analyzer (NIOX, Aerocrine, Sweden) according to American Thoracic Society guidelines, before and at 1, 2, 3 and 24 hours after bronchoscopy. Mean FE(NO) before bronchoscopy was 19.7+/-4.5 ppb (mean +/- SEM), post - bronchoscopy a decrease with a nadir at second hour (12.1+/-1.5 ppb, p<0.05) was observed, FE(NO) 24 hours after bronchoscopy was not different than baseline (18.4+/-2.5 ppb). There were no differences in the FE(NO) profile in BAL patients when compared to those in whom only the bronchial washing has been performed., Conclusions: Bronchoscopy leads to a significant decrease in exhaled nitric oxide. The underlying mechanisms are unclear. Future studies including analysis of other inflammatory markers are needed to explain these changes.

Bronchofiberoscopy is one of the basic diagnostic tools in pulmonary care. It is therefore of interest to assess the effects of this procedure on circulatory system as well as the risk of possible cardiovascular complications. The study included 56 patients for whom bronchoscopy was a planned diagnostic procedure (9 patients had additionally BAL). Each patient's examination protocol included, among others, ECG by Holter method, the measurement of arterial pressure and 12-lead ECG performed before and after the examination. The patients were divided into two groups: those with ventricular arrhythmia diagnosed by ECG at rest and those without arrhythmia signs in ECG done prior to bronchofiberoscopy. The analysis of data revealed that bronchofiberoscopy was associated with considerable increase of arterial pressure in both groups of patients as well as with increased ventricular arrhythmia, particularly in patients with previous history of arrhythmia. Additional load upon the respiratory system exerted by BAL did not have a significant effect on the circulatory system.

Bronchial asthma and chronic bronchitis in a stable period of the disease could be an indication for diagnostic bronchofiberoscopy. The aim of the authors of this article is to assess whether bronchoscopy may be safely used either as diagnostic or therapeutic procedure. 21 patients (age 33-46), 13 with atopic bronchial asthma and 8 with COPD took part in this study. The measurements were carried out one day before and 3 hours after the bronchoscopy. The following parameters: Forced Vital Capacity (FVC), Forced Expiratory Volume (FEV1), Forced Expiratory Flow (FEF25, FEF50, FEF75) and Resistance of Airways (R aw) were taken into consideration. It was shown that bronchofiberoscopy could be performed safely in these patients and did not lead to woersing ventilation parameters. Bronchospasm was not observed during the study. Moreover the increase in FEF50, FEF75 and R aw were observed. This significant decrease of amount of bronchial discharge could serve as an explanation of this phenomenon.

One of the initial indications for therapeutic bronchoscopy was removal of an aspirated foreign body. The aim of this study was to evaluate the role of bronchofiberoscopy in removal of aspirated foreign bodies. Thirty patients were included in the study (age range 4-81 years). Endoscopy was performed under local anesthesia in two sessions. During the first a complete evaluation of the tracheobronchial tree was carried out, while during the second the actual removal was performed. In the majority of the patients (23) the foreign body was aspirated into the right lung. In the majority of the patients (13) various fragments of bones were recovered. Only in one patient a major complication was observed (hemorrhage) which compelled to change from bronchofiberoscopy to rigid endoscopy. All complaints from patients subsided during 2-4 days after removal of the foreign body. Foreign bodies were removed using a bronchofiberoscope in 21 out of the 28 patients. In two patients a calcified lymph node could not be removed during bronchoscopy and the patients were referred to the Surgical Department for thoracotomy.