Ibuprofen does not prevent postbronchoscopy fever in children undergoing broncho‐alveolar lavage

• Published in: Pediatric pulmonology 2020-10, Vol.55 (10), p.2737-2741
• Main Authors: Joseph, Leon, Goldberg, Shmuel, Cohen, Shlomo, Picard, Elie
• Format: Article
• Language: English
• Subjects: Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Bronchoalveolar Lavage - adverse effects; Bronchoscopy; Bronchoscopy - adverse effects; Child; Child, Preschool; children; Double-Blind Method; Female; fever; Fever - drug therapy; Humans; ibuprofen; Ibuprofen - therapeutic use; Infant; Lavage; Male; Nonsteroidal anti-inflammatory drugs; Pediatrics; Treatment Outcome
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.24992

Background Fiber‐optic bronchoscopy (FOB) of the lower airways is a routine examination performed for investigating varying respiratory complaints in children. A common side effect is a transient high fever on the day of the FOB. Such episodes are usually unrelated to an infectious process but may cause clinical uncertainty and parental anxiety. We have previously shown that a single dose of systemic dexamethasone significantly reduces the rate of fever postbronchoscopy (FPB). Research Question To prospectively analyze the effect of a prophylactic dose of ibuprofen upon the FPB. Study Design and Methods Children presenting for elective FOB and broncho‐alveolar lavage (BAL) were randomized, in a double‐blind fashion, to receive a single dose of ibuprofen syrup 10 mg/kg or placebo prior to the procedure. Parents were contacted the next day to record the presence or absence of fever. Results Sixty‐one children were included in the final analysis. Thirty‐one children were in the treatment group and 30 in the placebo group. FPB occurred in 40 children (65%). There was no difference in the rate of FPB between placebo (63%) and treatment (67%) groups (P = .717). Fifty (82%) children had a positive BAL culture. Among them, 38 had FPB (76%) compared with only 2 of 11 (18%) of those with negative culture (P = .00026, relative risk 4.18). About 80% of positive cultures grew Haemophilus influenza. There was no significant difference between the number of BALs with a positive culture between the treatment and placebo groups (87% vs 77%, P = .35). Conclusion FPB occurs in around twothirds of children when BAL is performed. Fever occurred significantly more frequently when BAL culture is positive. A single standard dose of the nonsteroidal anti‐inflammatory drug ibuprofen administered before a FOB does not prevent FPB.