Division of Pulmonary and sleep medicine, Children's Hospital Of Philadelphia, Philadelphia, PA.
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA.
Pediatr Pulmonol. 2024 Jun;59(6):1708-1715. doi: 10.1002/ppul.26977. Epub 2024 Apr 1.
Advanced diagnostic bronchoscopy includes endobronchial ultrasound (EBUS) guided transbronchial lung and lymph node biopsies, CT navigation and robotic bronchoscopy. Interventional bronchoscopy refers to procedures performed for therapeutic purposes such as balloon dilation of the airway, tissue debulking, cryotherapy, removal of foreign bodies and insertion of endobronchial valves [1]. For adult patients, these procedures are standard of care [2, 3]. Despite a lack of formalized training, there are numerous case reports and case series describing the use of advanced diagnostic and interventional bronchoscopy techniques in children. The safety and feasibility of EBUS-TBNA, cryotherapy techniques, endobronchial valves among other techniques have been demonstrated in these publications [1, 4-9].
We sought to better understand the current practices and perspectives on interventional and advanced bronchoscopy among pediatric pulmonologists through surveys sent to pediatric teaching hospitals across the United States.
We received 43 responses representing 28 programs from 25 states. The highest bronchoscopy procedure volume occurred in the 0-5 years age group. Among our respondents, 31% self-identified as a pediatric interventional/advanced bronchoscopist. 79% believe that advanced and interventional training is feasible in pediatric pulmonology and 77% believe it should be offered to pediatric pulmonary fellows.
This is the first study to characterize current practices and perspectives regarding advanced diagnostic and interventional bronchoscopy procedures among pediatric pulmonologists in the United States. Pediatric interventional pulmonology (IP) is in its infancy and its beginnings echo those of the adult IP where only certain centers were performing these procedures.
高级诊断性支气管镜检查包括经支气管超声（EBUS）引导的经支气管肺和淋巴结活检、CT 导航和机器人支气管镜检查。介入性支气管镜检查是指为治疗目的而进行的程序，例如气道球囊扩张、组织减容、冷冻疗法、异物去除和支气管内瓣膜插入[1]。对于成年患者，这些程序是标准治疗方法[2,3]。尽管缺乏规范化的培训，但有许多病例报告和病例系列描述了在儿童中使用高级诊断和介入性支气管镜技术。在这些出版物中，已经证明了 EBUS-TBNA、冷冻技术、支气管内瓣膜等技术的安全性和可行性[1,4-9]。
我们通过向美国各地的儿科教学医院发送调查，试图更好地了解儿科肺科医生对介入性和高级支气管镜检查的当前实践和观点。
我们收到了 43 份代表 28 个项目的来自 25 个州的回复。支气管镜检查程序量最高的是 0-5 岁年龄组。在我们的受访者中，31%的人自认为是儿科介入/高级支气管镜检查医师。79%的人认为在儿科肺病学中进行高级和介入培训是可行的，77%的人认为应该向儿科肺科研究员提供这些培训。
这是第一项描述美国儿科肺科医生在高级诊断性和介入性支气管镜检查程序方面的当前实践和观点的研究。儿科介入性肺病学（IP）仍处于起步阶段，其发展轨迹与成人 IP 相似，只有某些中心在开展这些程序。
