Fibre‐optic bronchoscopy in adults: a position paper of The Thoracic Society of Australia and New Zealand

Wood‐Baker, Richard; Burdon, Jonathan; McGregor, Ali; Robinson, Patrick G; Seal, Philippa

doi:10.1046/j.1445-5994.2001.00104.x

Cited by 39 publications

(27 citation statements)

References 44 publications

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“…1 Current guidelines for bronchoscopy recommend offering sedation to patients, with the aim of improving patient comfort and cooperation, and reducing complications. 2,3 There is currently no agreement on the W Liao, G Ma, QG Su et al…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine versus Midazolam for Conscious Sedation in Postoperative Patients Undergoing Flexible Bronchoscopy: A Randomized Study

Liao

Gertz

et al. 2012

J Int Med Res

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OBJECTIVE: This prospective randomized study evaluated the efficacy and patient tolerance of dexmedetomidine compared with midazolam for sedation in postoperative patients undergoing flexible bronchoscopy. METHODS: A total of 198 postoperative patients were randomized to receive dexmedetomidine (n = 99) or midazolam (n = 99) to produce conscious sedation for bronchoscopy. Peripheral oxygen saturation, heart rate and systolic and diastolic arterial pressures were recorded before, during and after the procedure. Patient tolerance was recorded using various visual analogue scales. RESULTS: The mean lowest peripheral oxygen saturation was significantly lower in the midazolam group than in the dexmedetomidine group. Heart rate and systolic arterial pressure were both significantly higher during bronchoscopy in the midazolam group than in the dexmedetomidine group. Bronchoscopy was well tolerated in both groups; there was no betweengroup difference in patient discomfort scores or in the percentage of patients who would accept repeat bronchoscopy. CONCLUSIONS:Compared with midazolam, dexmedetomidine provided better oxygen saturation and was equally well tolerated for conscious sedation in postoperative patients undergoing bronchoscopy.

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Section: Introductionmentioning

confidence: 99%

Dexmedetomidine versus Midazolam for Conscious Sedation in Postoperative Patients Undergoing Flexible Bronchoscopy: A Randomized Study

Liao

Gertz

et al. 2012

J Int Med Res

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“…Nevertheless, it is pointed out that the disinfector and the bronchoscope must be compatible, otherwise the risk of contamination may increase (5). If the bronchoscope and the machine are not compatible, it will be more suitable to disinfect the equipment manually.…”

Section: Discussionmentioning

confidence: 99%

“…Whereas many international organisations, most notably the American Thoracic Society (ATS), European Respiratory Society (ERS), British Thoracic Society (BTS) and American College of Chest Physicians (ACCP), have tried to standardise bronchoscopy and other interventional pulmonology procedures to some extent, as bronchoscopy education, applications and experience are not uniform, both worldwide and in our country (2)(3)(4)(5)(6)(7)(8). For example, in a survey conducted by the ACCP, more than 50% of the participants stated that their training was not adequate for advanced diagnostic procedures such as TBNA (2).…”

Section: Discussionmentioning

confidence: 99%

“…There have been various guidelines published for different bronchoscopy applications (interventional, diagnostic etc.) by various international associations and institutions (2)(3)(4)(5)(6)(7)(8). While these guidelines are actually "guiding", since randomised controlled clinical trials are generally inadequate, their evidence levels are relatively low compared to the guidelines in other medical practices.…”

Section: Introductionmentioning

confidence: 99%

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Bronchoscopy Practice in Turkey: A Questionnaire Study

Tozkoparan¹,

Çağlayan²,

Dalar³

et al. 2014

Eurasian J Pulmonol

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Objective: As in the rest of the world, there are differences in attitudes and behaviours among physicians in bronchoscopy applications in our country as well. The aim of this study was to put forward the attitudes and behaviours of bronchoscopists using a questionnaire as the Working Group of Interventional Pulmonology of Turkish Respiratory Society. Methods:The invitation letter prepared individuals for participation in the web-based questionnaire containing 23 questions on the implementation of diagnostic and interventional bronchoscopy; the link to the questionnaire was sent to the e-mail groups of pulmonologists, thoracic surgeons and anesthesia and intensive care specialists. The responses of the physicians participating to the questionnaire were evaluated. The results obtained from the questionnaire were evaluated generally and on the basis of medical branches by statistical analyses. Results:The questionnaire was answered by a total of 146 specialists including 93 pulmonologists, 30 thoracic surgeons and 23 anesthesiologists. In total, 73% of the physicians responding to the questionnaire were working at the University or Training and Research Hospital and 47% of the respondents were conducting more than 100 bronchoscopies per year. Here, 36% of the respondents stated that in the bronchoscopies that they carried out, they did not sedate their patients. On the other hand, the most commonly preferred medication for sedation was midazolam (78%). While 77% of the pulmonologists used nebulised lidocaine as a topical anesthetic, these rates were 12.5% and 8.3% respectively for thoracic surgeons and anaesthesiologists (p<0.001). Also, 38% of pulmonologists were conducting 23% of the diagnostic bronchoscopies under general anesthesia. During bronchoscopy, the pulse oximetry follow-up was found to be 97%, and the supplemental oxygen administration was 87%. Overall, 60% of the pulmonologists thought that at least 100 procedures must be performed under the supervision of a specialist during bronchoscopy training and 40% of them were of the opinion that the number of procedures undertaken must be at least 50. Conclusion:The data of the survey give information about the practice of bronchoscopy in Turkey. It is suggested that the repetition of such questionnaires by increasing the variety of questions and the number of participants will provide an important data source.

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“…There are no controlled studies of the factors which may make a patient totally unfit for the procedure, so a decision to perform a bronchoscopy is a balance between the likely benefit of obtaining diagnostic material (including therapeutic benefit) and an assessment of the likely risk for complications in that individual patient. (BTS, 2001;ATS, 1987;Ernst et al,2003;Wood-Baker et al, 2001) Relative contraindications to bronchoscopy include severe respiratory insufficiency when bronchoscopy will be non-therapeutic, inability to maintain a patent airway and severe cardiovascular instability. Coagulopathy when biopsy is considered and severe generalized debilitated status are other relative factors to be considered prior to bronchoscopy.…”

Section: Contraindicationsmentioning

confidence: 99%