Cost Comparison of Single-Use Versus Reusable Bronchoscopes Used for Percutaneous Dilatational Tracheostomy

Sohrt, Anne; Ehlers, Lars Holger; Udsen, Flemming Witt; Mærkedahl, Anders; McGrath, Brendan A.

doi:10.1007/s41669-018-0091-2

Cited by 12 publications

(11 citation statements)

References 17 publications

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“…For reusable bronchoscopes, the costs per bronchoscopy decreased with a higher number of interventions. In contrast, a recent meta-analysis on cost effectiveness of single-use versus reusable bronchoscopes for PDT claimed single-use devices more cost effective [ 23 ], but disinfection costs in this analysis were far higher than in our institution and the main savings were achieved when additional expenses for the treatment of pneumonia due to the risk of cross-contamination, i.e. insufficient disinfection and spread of pathogens from one to the next patient, were included.…”

Section: Discussionmentioning

confidence: 71%

Percutaneous dilatational tracheostomy with single use bronchoscopes versus reusable bronchoscopes – a prospective randomized trial (TraSUB)

et al. 2022

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Background Apart from conventional reusable bronchoscopes, single-use bronchoscopes (SUB) were recently introduced. Data suggest that SUB might prevent from the risk of cross contamination (i.e. multiresistant pathogens, SARS CoV-2) and save costs. We aimed to investigate visualization, ventilation, handling characteristics, changes in patients’ gas exchange, and costs associated with both types of bronchoscopes during percutaneous dilatational tracheostomy (PDT). Methods In this prospective, randomized, noninferiority study, 46 patients undergoing PDT were randomized 1:1 to PDT with SUB (Ambu aScope) or reusable bronchoscopes (CONV, Olympus BF-P60). Visualization of tracheal structures rated on 4-point Likert scales was the primary end-point. Furthermore, quality of ventilation, device handling characteristics, changes in the patients’ gas exchange, pH values, and costs were assessed. Results Noninferiority for visualization (the primary endpoint) was demonstrated for the SUB group. Mean visualization scores (lower values better) were 4.1 (95% confidence intervals: 3.9;4.3) for SUB vs. 4.1 (4.0;4.2) for CONV. Noninferiority of ventilation (estimated by minute volume and SpO2) during the procedure could be shown as well. Mean score was 2.6 (2.0;3.1) for SUB vs. 2.4 (2.1;2.7) for CONV (lower values better). No significant differences regarding handling (SUB: 1.2 (1.0;1.4), CONV: 1.3 (1.1;1.6)), blood gas analyses and respiratory variables were found. Cost analysis in our institution revealed 93 € per conventional bronchoscopy versus 232.50 € with SUB, not considering an estimate for possible infection due to cross-contamination with the reusable device. Conclusion In our study, visualization and overall performance of the SUB during PDT were noninferior to reusable bronchoscopes. Therefore, PDT with SUB is feasible and should be considered if favored by individual institution’s cost analysis. Trial registration. ClinicalTrials.gov, NCT03952247. Submitted for registration on 28/04/2019 and first posted on 16/05/2019.

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Section: Discussionmentioning

confidence: 71%

Percutaneous dilatational tracheostomy with single use bronchoscopes versus reusable bronchoscopes – a prospective randomized trial (TraSUB)

et al. 2022

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“…In that review, neither included the repair cost of RFBs nor performed a statistical analysis as performed in this meta-analysis. The authors assessed the repair cost via a survey and found that the percutaneous dilatory tracheostomy procedure cost was higher than the procedure cost for intubation [ 44 ]. It makes it impossible to know whether the cost difference between RFBs and SFBs was statistically significant.…”

Section: Discussionmentioning

confidence: 99%

The Cost of Flexible Bronchoscopes: A Systematic Review and Meta-analysis

Andersen

Travis

Dehlholm-Lambertsen³

et al. 2022

PharmacoEconomics Open

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Background and Objective Until 2009, only reusable bronchoscopes were marketed, but the introduction and widespread adoption of single-use flexible bronchoscopes (SFBs) as an emerging technology has since accelerated. Several studies have described the costs of reusable flexible bronchoscopes (RFBs) and SFBs. This meta-analysis aimed to compile the current published evidence to analyse the cost of different scenarios using RFBs and SFBs. Methods All published literature describing the cost of RFBs or SFBs was identified by searching PubMed, Embase and Google Scholar, limited to those between 1 January, 2009 and 6 November, 2020. Included studies should report the total cost of RFBs. Continuous data were extracted for relevant outcomes and analysed using RStudio ® 4.0.3 as the standardised mean difference and standard error of the mean in a mixed-effects model. Risk of bias was assessed based on the reporting quality. Results In the systematic literature review, 342 studies were initially identified, and 11 were included in the final analysis.

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“…mask [ 72 ], utilising 3D printing [ 73 ] and reusable device, e.g. bronchoscopes, [ 74 ]. Liao et al.…”

Section: Future Ppe and Environmentally Sustainable Measuresmentioning

confidence: 99%

The energy and environmental footprints of COVID-19 fighting measures – PPE, disinfection, supply chains

Klemeš

Fan

Jiang

2020

Energy

223

185

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The still escalating COVID-19 pandemic also has a substantial impact on energy structure, requirements and related emissions. The consumption is unavoidable and receives a lower priority in the critical situation. However, as the pandemic continues, the impacts on energy and environment should be assessed and possibly reduced. This study aims to provide an overview of invested energy sources and environmental footprints in fighting the COVID-19. The required energy and resources consumption of Personal Protection Equipment (PPE) and testing kits have been discussed. The protecting efficiency returned on environmental footprint invested for masks has been further explored. The main observation pinpointed is that with a proper design standard, material selection and user guideline, reusable PPE could be an effective option with lower energy consumption/environmental footprint. Additional escalated energy consumption for aseptic and disinfection has been assessed. This includes the energy stemming from emergency and later managed supply chains. The outcomes emphasised that diversifying solutions to achieve the needed objective is a vital strategy to improve the susceptibility and provide higher flexibility in minimising the environmental footprints. However, more comprehensive research proof for the alternative solution (e.g. reusable option) towards low energy consumption without compromise on the effectiveness should be offered and advocated.

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Cost Comparison of Single-Use Versus Reusable Bronchoscopes Used for Percutaneous Dilatational Tracheostomy

Abstract: We conclude that significant savings can be made by using single-use bronchoscopes to guide PDT in preference to reusable bronchoscopes. Results depend on hospital setting, the reprocessing procedures, annual bronchoscope procedures, individual repair cost, and repair rates.

Cited by 12 publications

References 17 publications

Percutaneous dilatational tracheostomy with single use bronchoscopes versus reusable bronchoscopes – a prospective randomized trial (TraSUB)

Percutaneous dilatational tracheostomy with single use bronchoscopes versus reusable bronchoscopes – a prospective randomized trial (TraSUB)

The Cost of Flexible Bronchoscopes: A Systematic Review and Meta-analysis

The energy and environmental footprints of COVID-19 fighting measures – PPE, disinfection, supply chains

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