Swedish study participants undergoing research bronchoscopy – a tolerable or unpleasant experience?

Flexible bronchoscopy is regarded as a safe examination and is commonly used in the diagnostic work-up for lung diseases, but is also important in pulmonary research. We aimed to investigate participants' experiences when undergoing bronchoscopy in a research setting. Participants were recruited from the Swedish CArdioPulmonary bioImage Study (SCAPIS). A subset from this cohort (n = 45, mean age 60.5 years, 20 with normal lung function and 25 with chronic obstructive pulmonary disease, COPD) was selected for bronchoscopy. The procedure was explained both orally and in writing during a pre-procedure visit. The information included premedication, monitoring, local anesthesia, airway sampling bronchoalveolar lavage (BAL), bronchial wash, and mucosal biopsies, and urine and blood samples. Questionnaires pre- and/or post-procedure were used to assess experiences and health impacts. In general, participants found the bronchoscopy procedure acceptable and only a few (18%) found it unpleasant. A majority (80%) reported their experience to be much better or as expected. Almost all participants (93%) were very satisfied with the information provided. Topical anesthesia was seen as more unpleasant (20%) than airway sampling (11%). Notably, more women and participants with normal lung function reported BAL as unpleasant. After the procedure, chills, fever, and hemoptysis were reported, but no serious adverse events occurred. Increased cough and phlegm were noted. The present study, conducted by experienced bronchoscopists and healthcare teams, demonstrates that a bronchoscopy in a research setting in well-informed participants with normal lung function or COPD was well-tolerated.