Abstract
Introduction: Chronic cough is associated with serious morbidity and it is imperative that physicians investigate the complaint thoroughly. Bronchoscopy can provide a wealth of information, which can aid diagnosis and treatment, but it is invasive and carries risk.
Objectives: To review bronchoscopy practices at the tertiary cough clinic in south Manchester.
Methods: We reviewed electronic case notes of all patients referred for bronchoscopy over an 18 month period for chronic cough, documenting indications, complications, findings and treatment outcomes.
Results: Of the 600 new patients reviewed in our clinic between 1st May 2017 and 31st October 2018, 96 (16%) were referred for a bronchoscopy. The most common indication was “suspected eosinophilic bronchitis (EB)” (40, 43%). Only 2 (2%) could not tolerate the procedure. Local sedation guidelines were followed for all remaining 94 patients.
The majority (76, 80%) had macroscopically abnormal findings, the most common being tracheobronchomalacia or excessive dynamic airways collapse (28, 30%).
All 94 patients had bronchioalveolar lavage (BAL) and 92 (98%) had endobronchial biopsies. Four (4%) had eosinophils of >3% on BAL (the accepted cut off for EB). Although 8 (9%) had eosinophils on biopsy, there was no correlation with BAL eosinophils.
There were 8 cases of bleeding requiring cold saline/adrenaline caused by endobronchial biopsies.
Conclusions: In a tertiary clinic setting, bronchoscopy is well tolerated in chronic cough patients. There are few complications and a high pick up rate of macroscopic abnormalities, with EB occurring infrequently. Clear guidance about the utility of bronchoscopy is lacking when investigating chronic cough.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA611.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019