Reduction of post-bronchoscopy pneumonia by working channel irrigation with sterile saline before diagnostic procedures

Background/Question After transbronchial biopsy with flexible bronchoscopy, pneumonia sometimes occurs as a complication. The goal of our study was to determine whether irrigation of the working channel before diagnostic procedures can reduce the frequency of post-bronchoscopy pneumonia. Methods Initially, we examined the effect of working channel irrigation with 100 mL of sterile saline to reduce the number of bacteria attached to the working channel. Subsequently, we compared the frequency of post-bronchoscopy pneumonia in patients who underwent or did not undergo working channel irrigation before bronchoscopic biopsy or lavage fluid collection. Results A significant reduction in bacterial colonies was observed in the irrigated channel-flush samples. Of the 242 enrolled participants, 109 were in the exploratory group, whereas 133 were in the control group. The frequency of post-bronchoscopy pneumonia was 2.8% (n = 3) and 3.8% (n = 5) in the exploratory and control groups, respectively. Conclusions/Answer to the question Irrigation by suctioning 100 mL of sterile saline significantly reduced the number of bacteria in the flexible bronchoscopy working channel. To confirm the practical significance of irrigation in reducing post-bronchoscopy pneumonia and post-bronchoscopy fever, further evaluation with additional cases from other institutions is required.