Safety of investigative bronchoscopy in the Severe Asthma Research Program.
Safety of investigative bronchoscopy in the Severe Asthma Research Program.
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DOI：
10.1016/j.jaci.2011.02.042
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发表时间：
2011-08
期刊：
影响因子：
--
通讯作者：
National Heart, Lung, and Blood Institute's Severe Asthma Research Group
中科院分区：
文献类型：
--
作者：
Moore WC;Evans MD;Bleecker ER;Busse WW;Calhoun WJ;Castro M;Chung KF;Erzurum SC;Curran-Everett D;Dweik RA;Gaston B;Hew M;Israel E;Mayse ML;Pascual RM;Peters SP;Silveira L;Wenzel SE;Jarjour NN;National Heart, Lung, and Blood Institute's Severe Asthma Research Group
在严重哮喘研究项目（SARP）的一部分参与者中进行了研究性支气管镜检查，以深入了解严重疾病的病理生物学。我们在该队列中评估了该手术的安全性，特别关注重度哮喘患者。前瞻性评价与研究性支气管镜检查相关的肺功能变化和不良事件频率。支气管镜检查使用通用操作手册进行。极重度哮喘的亚组定义为重度气流阻塞、长期口服皮质类固醇和近期哮喘急性发作。监测受试者的肺功能变化，并在术后3天通过电话联系。436例受试者接受了支气管镜检查（97例正常，196例非重度，102例重度和41例极重度哮喘）。9例受试者在支气管镜检查后在医院接受了评价;其中7例为呼吸相关事件。在支气管镜检查后哮喘恶化的受试者中，最近去急诊室就诊、长期口服皮质类固醇使用和肺炎史的频率更高。重度哮喘组与轻度哮喘组相比，支气管镜检查后FEV 1的下降相似。使用支气管扩张剂前FEV 1是支气管镜检查后FEV 1变化的最强预测因子，在肺功能较好的受试者中观察到较大的下降。严重哮喘患者的支气管镜检查耐受性良好。哮喘急性发作罕见，手术后肺功能降低与哮喘不太严重的受试者相似。在适当的预防措施下，研究性支气管镜检查可以安全地用于重度哮喘。
Investigative bronchoscopy was performed in a subset of participants in the Severe Asthma Research Program (SARP) to gain insights into the pathobiology of severe disease. We evaluated the safety aspects of this procedure in this cohort with specific focus on patients with severe asthma. To prospectively evaluate changes in lung function and the frequency of adverse events related to investigative bronchoscopy. Bronchoscopy was performed using a common Manual of Procedures. A subset of very severe asthma was defined by severe airflow obstruction, chronic oral corticosteroid use and recent asthma exacerbations. Subjects were monitored for changes in lung function and contacted by telephone for 3 days after the procedure. 436 subjects underwent bronchoscopy (97 normal, 196 not severe, 102 severe and 41 very severe asthma). Nine subjects were evaluated in hospital settings after bronchoscopy; seven of these were respiratory related events. Recent Emergency Department visits, chronic oral corticosteroid use and a history of pneumonia were more frequent in subjects who had asthma exacerbations after bronchoscopy. The fall in FEV1 following bronchoscopy was similar in the severe compared to milder asthma group. Pre-bronchodilator FEV1 was the strongest predictor of change in FEV1 after bronchoscopy with larger decreases observed in subjects with better lung function. Bronchoscopy in severe asthma subjects was well tolerated. Asthma exacerbations were rare and reduction in pulmonary function after the procedure was similar to subjects with less severe asthma. With proper precautions, investigative bronchoscopy can be performed safely in severe asthma.
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影响因子：
24.3
作者：
Elston, WJ;Whittaker, AJ;Barnes, NC
通讯作者：
Barnes, NC
影响因子：
10
作者：
Humbert, M;Robinson, DS;Durham, SR
通讯作者：
Durham, SR
影响因子：
14.2
作者：
Julius, Peter;Lommatzsch, Marek;Virchow, Johann Christian
通讯作者：
Virchow, Johann Christian
DOI：
10.1164/ajrccm/143.4_pt_1.772
发表时间：
1991-04-01
期刊：
AMERICAN REVIEW OF RESPIRATORY DISEASE
影响因子：
--
作者：
DJUKANOVIC, R;WILSON, JW;HOWARTH, PH
通讯作者：
HOWARTH, PH
影响因子：
14.2
作者：
Moore, Wendy C.;Bleecker, Eugene R.;Wenzel, Sally E.
通讯作者：
Wenzel, Sally E.