A survey of flexible bronchoscopy practices in India: The Indian bronchoscopy survey (2017)

Madan, Karan; Mohan, Anant; Agarwal, Ritesh; Hadda, Vijay; Khilnani, Gopi C; Guleria, Randeep

doi:10.4103/lungindia.lungindia_417_17

Cited by 37 publications

(23 citation statements)

References 25 publications

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“…Similar observations were reported in the adult bronchoscopy surveys as well. In an Indian survey of bronchoscopy practices in adults, bronchoscopy was performed using only topical anesthesia and without conscious sedation in 59% of patients 5 . In our study, almost all respondents reported the use of intravenous sedation for performing bronchoscopy.…”

Section: Discussionmentioning

confidence: 61%

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A survey of pediatric flexible bronchoscopy in India

Jat

Agarwal

Lodha

et al. 2022

Pediatric Pulmonology

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Background: A bronchoscopy is an essential tool in pediatric pulmonology. However, the practices involved in the procedure are variable.Objective: To evaluate prevalent practices and variations in pediatric flexible bronchoscopy in India.Methods: An online survey was conducted via Google forms between September 2018 and March 2019. We circulated the survey among members of various respiratory societies and personal contacts. Physicians performing pediatric flexible bronchoscopy were requested to respond. The survey had 95 questions in seven domains: demographics, patient preparation, sedation, procedural aspects, monitoring, bronchoscope cleaning, and complications. Results:The survey received 24 complete responses; the respondents were from 14 cities. Pediatric bronchoscopy was done mainly for diagnostic purposes. Most (19, 79%) respondents reported using conscious sedation for the procedure. The preferred regimen for sedation was midazolam plus fentanyl [9 (37.5%)]. Atropine was used routinely by 4 (16%). For topical anesthesia, nebulized lignocaine only, both nebulized and spray as go lignocaine, and spray as go lignocaine only were used by 1 (4.2%), 6 (25%), and 17 (71%) respondents, respectively. The methods of providing oxygen during bronchoscopy were free flow (9, 37.5%), nasal prongs (8, 33.3%), mask (6, 25%), and laryngeal mask airway (1, 4.2%). The common therapeutic procedures included removal of mucus plugs (17, 71%), bronchoscopic intubation (11, 45%), and foreign body removal (10, 41%). The number of aliquots used by respondents for bronchoalveolar lavage varied from 2 to 6, and the volume for each aliquot was also varied (1-2 ml/kg or 5-10 ml). Almost all the respondents reported complication rates of less than 5%. Conclusion:There is a considerable variation in pediatric flexible bronchoscopy practices across the country, highlighting the need to develop a uniform guideline.

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Section: Discussionmentioning

confidence: 61%

“…An important step in this direction is to assess the current present practices. There are surveys evaluating the bronchoscopy practices in adult patients from various countries such as Canada, 1 UK, 2 Japan, 3 Australia and New Zealand, 4 and India 5 . Similar surveys conducted exclusively in pediatrics are scarce.…”

Section: Introductionmentioning

confidence: 99%

A survey of pediatric flexible bronchoscopy in India

Jat

Agarwal

Lodha

et al. 2022

Pediatric Pulmonology

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“…Like the observations from the “Indian Bronchoscopy Survey-2017,” the EBUS-TBNA facilities are concentrated in few cities. [ 6 ] The resource-related requirements, and this being a specialized procedure, are evident from the observation that most respondents were working in multispecialty settings or medical colleges. There is an unmet need for increasing the EBUS-TBNA training avenues, as only 40% of respondents had received training as part of a formal training program.…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 ] However, like flexible bronchoscopy, there is variability in the performance technique in different settings. [ 6 ] Although a few international guidelines have attempted to provide guidance aimed at standardization of the procedure, there are many unaddressed issues related to the procedural aspects of EBUS-TBNA. [ 7 ]…”

Section: Introductionmentioning

confidence: 99%

“…However, online surveys are preferred and feasible, as demonstrated in India’s recent nationwide bronchoscopy study and a recent study of pleuroscopy practice in India. [ 6 8 ] The current survey was designed to study the prevalent practices of EBUS-TBNA in India. We aimed to explore the multiple aspects of the linear EBUS-TBNA procedure, including demographics, topical anesthesia and sedation, technical factors, complications, and infection control related to the procedure.…”

Section: Introductionmentioning

confidence: 99%

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A Survey of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) practices in India

et al. 2022

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Background: There is a lack of data on the prevalent practices of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in India. Aim: To study the current practices of EBUS-TBNA in India. Methods: This survey was an online questionnaire designed on the Google forms interface. The survey included various questions related to demographics, sedation, analgesia and anesthesia, technical aspects, and infection control related to the procedure of EBUS-TBNA. Results: Data from 134 respondents (mean age: 42.2 years) were analyzed. Most (97.8%) were pulmonologists or physicians, and a majority (94.8%) practicing in either a private multi-specialty setting or medical college. 40.3% had received procedure training at a formal training program. Mild/moderate sedation was the most common strategy (70.1%). Midazolam (76.7%), Fentanyl (76.0%), followed by propofol (46.5%), were the most frequent drugs, and 82.8% preferred combination sedation. 26.1% used cricothyroid lignocaine injection, and the use of 1% or 2% lignocaine for spray-as-you-go administration was similar. The oral route was preferred, while the laryngeal mask airway was the most common airway conduit under general anesthesia. Suspected granulomatous mediastinal lymphadenopathy (TB/sarcoidosis) (67.2%), followed by lung cancer (32.8%), were the most common indications of EBUS-TBNA. 81.3% performed EBUS-TBNA for lung cancer staging. 21 G needle was preferred (64.9%), and vacuum suction was common (80.6%). 55.2% routinely performed ROSE. Alcohol fixed glass slide smears were the most common method (93.1%) for cytological preparation. 49.3% also performed EUS-B-FNA. 76.9% routinely obtained endo bronchial biopsy and transbronchial lung biopsy in patients with suspected sarcoidosis. Elastography was infrequently used. Nearly three-fourths (77.6%) reused EBUS needles. Conclusion: There is practice variability in the multiple aspects related technical performance of EBUS-TBNA. Evidence-based guidelines addressing the multiple technical aspects are required to standardize the practice of EBUS-TBNA.

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