Sindhwani Girish, Mishra Mayank, Gangakhedkar Mihir Raman, Madan Karan, Dua Ruchi, Sharma Prakhar, Saini Lokesh Kumar
Department of Pulmonary Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.
Lung India. 2021 Mar;38(Supplement):S48-S52. doi: 10.4103/lungindia.lungindia_357_20.
Bronchoscopy is an extremely useful diagnostic and therapeutic procedure that finds an invaluable place in Pulmonology practice. Due to aerosol generation, bronchoscopy carries a high risk of infection transmission to health care workers and other patients. This fact is even more important in the present times of COVID-19 pandemic owing to its droplet- (and possibly aerosol-) mediated spread. With this background, a working group extracted literature through electronic search of PubMed and Google Scholar databases. All relevant documents were comprehensively reviewed and consensus recommendations formulated based on the level of available evidence. Where evidence was insufficient, Usual Practice Points were formulated based on expert opinion. This resultant document attempts to present clinical recommendations for performing flexible bronchoscopy in COVID-19 suspect/confirmed patients. It outlines important general considerations for bronchoscopy in these cases, provides an algorithmic approach to patient selection for bronchoscopy during these extraordinary times, and enlists critical do's and don'ts that should be followed before, during, and after the procedure. To conclude, flexible bronchoscopy must be cautiously performed amid the COVID-19 crisis. Judicious case selection and meticulous contact and airborne precautions are important to minimise infection transmission.
支气管镜检查是一种极其有用的诊断和治疗手段，在肺病学实践中占有重要地位。由于会产生气溶胶，支气管镜检查存在将感染传播给医护人员和其他患者的高风险。在当前新冠疫情期间，由于其通过飞沫（可能还有气溶胶）传播，这一事实显得尤为重要。在此背景下，一个工作组通过电子检索PubMed和谷歌学术数据库提取文献。对所有相关文件进行了全面审查，并根据现有证据水平制定了共识性建议。在证据不足的情况下，根据专家意见制定了常规实践要点。这份文件试图为在新冠疑似/确诊患者中进行柔性支气管镜检查提供临床建议。它概述了这些情况下支气管镜检查的重要一般注意事项，提供了在这些特殊时期进行支气管镜检查患者选择的算法方法，并列出了在操作前、操作中和操作后应遵循的关键注意事项。总之，在新冠疫情危机期间，必须谨慎进行柔性支气管镜检查。明智地选择病例以及细致的接触和空气传播预防措施对于减少感染传播很重要。
