Recomendaciones de consenso SEPAR y AEER sobre el uso de la broncoscopia y la toma de muestras de la vía respiratoria en pacientes con sospecha o con infección confirmada por COVID-19

Abstract

scopia Respiratoria, con el objetivo de proporcionar conocimientos para el uso efectivo y seguro de la broncoscopia en pacientes con sospecha o con confirmación de la infección por COVID-19. Es prioritario proporcionar la mayor seguridad a nuestros pacientes, a los sanitarios que los atienden y a la comunidad en general. En este momento de pandemia, la información de la que disponemos acerca del uso de la broncoscopia en este tipo de pacientes se basa en la experiencia de otros centros y países, y las publicaciones científicas son escasas. El objetivo de este documento es recoger esas experiencias y, en base a las recomendaciones de los organismos oficiales, ofrecer un documento de ayuda para la práctica clínica diaria.

Summarizing societal guidelines regarding bronchoscopy during the COVID‐19 pandemic

“…Several bronchology societies have issued guidelines regarding bronchoscopy during the COVID‐19 pandemic . However, none are comprehensive and significant uncertainty remains regarding in whom to perform bronchoscopy and how to perform it safely in this rapidly changing clinical environment.…”

“… †Possible indications: inconclusive non‐invasive COVID‐19 testing; concern for an alternate aetiology of respiratory disease which would change management (especially in immunocompromised); suspicion of superinfection; and lobar or entire lung atelectasis concerning for mucus plugging, facilitate tracheostomy, life‐saving or emergent intervention (significant haemoptysis, severe central airway obstruction or stenosis, foreign body) …”

Bronchoscopist's Perception of the Quality of the Single-use Fiberoptic Bronchoscope (Ambu Ascope4 ™) in Conventional Bronchoscopies. A Multicenter Study in 21 Spanish Pulmonology Services.

“…They highlighted its portability, immediacy to start the procedure and the possibility of storing the images. (8)(9)(10)(11) However, these advantages would be of little value if the bronchoscope did not fulfill its functions with quality.…”

“…A disposable bronchoscope could decrease the risk of cross infection and increase accessibility to bronchoscopy in centers of less complexity or with limited resources and has been recommended by most respiratory societies for bronchoscopies during the SARS-COv-2 pandemic. (8)(9)(10)(11) Patients on mechanical ventilation, (12) immunosuppressed or with infectious contagious diseases are those with the highest risk for cross infections and where these devices may have a more relevant role. These bronchoscopes are also desirable for procedures with a high risk of damage the bronchoscope (e.g.…”

Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4 ™) in selected bronchoscopies. A multicenter study in 21 Spanish pulmonology services

“…(5)(6)(7) A disposable bronchoscope could decrease the risk of cross infection and increase accessibility to bronchoscopy in centers of less complexity or with limited resources and has been recommended by most respiratory societies for bronchoscopies during the SARS-COv-2 pandemic. (8)(9)(10)(11) Patients on mechanical ventilation, (12) immunosuppressed or with infectious contagious diseases are those with the highest risk for cross infections and where these devices may have a more relevant role. These bronchoscopes are also desirable for procedures with a high risk of damage the bronchoscope (e.g.…”