Cytokines derived from alveolar macrophages induce fever after bronchoscopy and bronchoalveolar lavage

Malawians permit research bronchoscopy due to perceived need for healthcare

“…Detailed prospective studies report higher complication rates with mortality 0.1%, major events 0.5–1.7% and minor complications in 6.5% of subjects 17 18. In series documenting bronchoscopy with lavage procedures, the incidence of side-effects is approximately 30% owing to the pro-inflammatory effect of the lavage procedure 2 19 20. There were no deaths and no major side effects in this study.…”

Prospective Study of Fever and Pneumonia After Flexible Fiberoptic Bronchoscopy in Older People

“…It has been suggested that fever after FOB is a result of transient bacteremia, 22,23 but bacteremia is rarely detected in immunocompetent subjects who acquire fever after FOB 7,14,15,24 . Cytokines such as tumor necrosis factor (TNF) and interleukin‐6 (IL‐6) derived from alveolar macrophages may induce fever after bronchoalveolar lavage (BAL) 25 . Pneumonia after FOB has been thought to be related to obstructive atelectasis and infection produced by organisms present in the airway at the time of the procedures, 14–19 although most previous reports were published 2 or 3 decades ago, and the frequency of these adverse events were variable according to different reports 14–19 .…”

“…A recent prospective series examining safety of FOB reported an incidence of fever after FOB of 5.4%, 25 although in that series of patients, the mean ages of the nonfever and fever groups were 56.4 and 54.2, respectively. Another large cohort study examined the effects of age on the process of care and outcomes of FOB 20 .…”

Pulmonary involvement in diffuse cutaneous systemic sclerosis: broncheoalveolar fluid granulocytosis predicts progression of fibrosing alveolitis

“…BAL was performed as recommended by the American Thoracic Society and as described previously using an Olympus BF 1T20 fibreoptic bronchoscope 11. In brief, after pre-medication with atropine (0.5 mg) intravenously, hydrocodon (15 mg) subcuteaneously, and diazepam (5–10 mg) intravenously, and local anaesthesia with prilocaine the bronchoscope was wedged into a segment bronchus of the the right middle lobe and 150 ml of 0.9% natrium chloride solution (37°C) were instilled in 20 ml aliquots.…”