It has been suggested that fibemptic bronchoscopy may induce life-threatening bronchospasm in persons with asthma. The safety of bronchoscopy and bronchoalveolar lavage (BAL) with bilateral installation of 300 ml of saline solution was assessed prospectively in ten adults with mild asthma as a part ofa study of the lower respiratory tract in bronchospastic disease. Asthmatic subjects had pretreatment with intravenous aminophylline prior to bronchoscopy. Pulmonary function tests were performed prior to and immediately after the procedure, and values were compared to results in 12 normal adults undergoing bronchoscopy with BAL. One subject had mild bronchospasm

In previous research, we have demonstrated that parenterally administered terbutaline can augment resting cardiac function in patients with chronic obstructive pulmonary disease (COPD). Because the oral form of terbutaline is more widely utilized, a double-blind, randomized, crossover, placebo-controlled trial of the cardiopulmonary effects of oral terbutaline was conducted in ten patients with COPD. Right and left ventricular ejection fractions (RVEF and LVEF) were determined by first pass radionuclide angiography. There were no differences in spirometry and hemodynamic measurements between treatment and placebo days. Following 5 mg of oral terbutaline, there was a small but statistically significant increase in forced expiratory volume in 1 second and in heart rate, but no significant change in forced vital capacity or blood pressure. LVEF improved significantly with terbutaline both at rest (62% ± 6% vs. 67% ± 9%, mean ± SD) and during submaximal steady state exercise (61% ± 5% vs. 67% ± 10%). RVEF improved significantly at rest (64% ± 6% vs. 69% ± 5%), but not during sub-maximal steady state exercise (65% ± 6% vs. 68% ± 7%). Thus, oral terbutaline produces significant improvement in biventricular systolic pump performance at rest, and increases left ventricular ejection fraction during sub-maximal exercise in patients with moderate to severe COPD.

Body position can lead to respiratory symptoms and affect gas exchange in disease states. We describe a patient with carcinoma of the left lung in whom dyspnea and oxygen desaturation developed in the right lateral position only. Fiberoptic bronchoscopic study demonstrated a tumor mass protruding into the left main-stem bronchus, which caused further narrowing when the patient turned on his right side.