A Randomized, Placebo-Controlled Trial of Bronchodilators for Bronchoscopy in Patients With COPD*

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In contrast to asthma, the indication for bronchodilators prior to bronchoscopy in patients with COPD has not been properly investigated. We therefore performed a randomized, double-blind, placebo-controlled trial to determine whether use of a short-acting bronchodilator provides a protective effect in patients with COPD undergoing bronchoscopy.


One hundred twenty patients undergoing bronchoscopy were included. Patients with COPD were randomized to receive either 200 μg of salbutamol (n = 40) or placebo (n = 40) before bronchoscopy. Control patients (n = 40) did not receive any inhaled medication. Spirometry was performed before and 2 h after bronchoscopy in all patients. Sedative drug requirements and hemodynamic parameters were recorded.


Hemodynamic findings before, during, and after bronchoscopy were similar in patients with COPD randomized to either salbutamol or placebo (p = not significant for all). Compared to prebronchoscopy values, postbronchoscopy percentage of predicted FEV1 decreased significantly in all three groups: salbutamol (median, − 4.7%; interquartile range [IQR], − 13.3 to 6.6); placebo (median, − 4.8%; IQR, − 19.9 to 8.4); and control subjects (median, − 10.0%; IQR, − 20.2 to - 3.3) [p = 0.023]. The decrease in FEV1 was similar in all three patient groups (p = 0.432). The relative change in FEV1 was inversely correlated to the increasing severity of COPD as expressed by Global Initiative for Chronic Obstructive Lung Disease stages (p = 0.01).


Premedication with an inhaled short-acting β-agonist cannot be recommended in patients with COPD undergoing bronchoscopy.

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