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Bronchoscopic Myths and Legends: Flexible Bronchoscopy in Patients With Very Severe Lung Obstruction

It has been well established that flexible bronchoscopy and topical anesthesia can cause a decline in lung function, including a temporary reduction in FEV1 in normal patients and those with lung obstruction. Pulmonologists are asked frequently to evaluate and bronchoscope patients with very severe lung obstruction. We performed a literature search to evaluate the myth that flexible bronchoscopy is unsafe for patients with very severe lung obstruction. Myth: Flexible bronchoscopy is unsafe and should not be performed in patients with severe obstructive lung disease as defined by a Forced Expiratory Volume (FEV1) of <35% predicted.