Guidelines for diagnostic flexible bronchoscopy in adults: Joint Indian Chest Society/National College of chest physicians (I)/Indian association for bronchology recommendations

Anant Mohan, Karan Madan, Vijay Hadda, Pawan Tiwari, Saurabh Mittal, Randeep Guleria, G C Khilnani, S K Luhadia, R N Solanki, K B Gupta, Rajesh Swarnakar, S N Gaur, Pratibha Singhal, Irfan Ismail Ayub, Shweta Bansal, Prashu Ram Bista, Shiba Kalyan Biswal, Ashesh Dhungana, Sachin Doddamani, Dilip Dubey, Avneet Garg, Tajamul Hussain, Hariharan Iyer, Venkatnarayan Kavitha, Umasankar Kalai, Rohit Kumar, Swapnil Mehta, Vijay Noel Nongpiur, N Loganathan, P B Sryma, Raju Prasad Pangeni, Prajowl Shrestha, Jugendra Singh, Tejas Suri, Sandip Agarwal, Ritesh Agarwal, Ashutosh Nath Aggarwal, Gyanendra Agrawal, Suninder Singh Arora, Balamugesh Thangakunam, D Behera, Jayachandra, Dhruva Chaudhry, Rajesh Chawla, Rakesh Chawla, Prashant Chhajed, Devasahayam J Christopher, M K Daga, Ranjan K Das, George D'Souza, Raja Dhar, Sahajal Dhooria, Aloke G Ghoshal, Manoj Goel, Bharat Gopal, Rajiv Goyal, Neeraj Gupta, N K Jain, Neetu Jain, Aditya Jindal, S K Jindal, Surya Kant, Sandeep Katiyar, S K Katiyar, Parvaiz A Koul, Jaya Kumar, Raj Kumar, Ajay Lall, Ravindra Mehta, Alok Nath, V R Pattabhiraman, Dharmesh Patel, Rajendra Prasad, J K Samaria, Inderpaul Singh Sehgal, Shirish Shah, Girish Sindhwani, Sheetu Singh, Virendra Singh, Rupak Singla, J C Suri, Deepak Talwar, T K Jayalakshmi, T P Rajagopal, Anant Mohan, Karan Madan, Vijay Hadda, Pawan Tiwari, Saurabh Mittal, Randeep Guleria, G C Khilnani, S K Luhadia, R N Solanki, K B Gupta, Rajesh Swarnakar, S N Gaur, Pratibha Singhal, Irfan Ismail Ayub, Shweta Bansal, Prashu Ram Bista, Shiba Kalyan Biswal, Ashesh Dhungana, Sachin Doddamani, Dilip Dubey, Avneet Garg, Tajamul Hussain, Hariharan Iyer, Venkatnarayan Kavitha, Umasankar Kalai, Rohit Kumar, Swapnil Mehta, Vijay Noel Nongpiur, N Loganathan, P B Sryma, Raju Prasad Pangeni, Prajowl Shrestha, Jugendra Singh, Tejas Suri, Sandip Agarwal, Ritesh Agarwal, Ashutosh Nath Aggarwal, Gyanendra Agrawal, Suninder Singh Arora, Balamugesh Thangakunam, D Behera, Jayachandra, Dhruva Chaudhry, Rajesh Chawla, Rakesh Chawla, Prashant Chhajed, Devasahayam J Christopher, M K Daga, Ranjan K Das, George D'Souza, Raja Dhar, Sahajal Dhooria, Aloke G Ghoshal, Manoj Goel, Bharat Gopal, Rajiv Goyal, Neeraj Gupta, N K Jain, Neetu Jain, Aditya Jindal, S K Jindal, Surya Kant, Sandeep Katiyar, S K Katiyar, Parvaiz A Koul, Jaya Kumar, Raj Kumar, Ajay Lall, Ravindra Mehta, Alok Nath, V R Pattabhiraman, Dharmesh Patel, Rajendra Prasad, J K Samaria, Inderpaul Singh Sehgal, Shirish Shah, Girish Sindhwani, Sheetu Singh, Virendra Singh, Rupak Singla, J C Suri, Deepak Talwar, T K Jayalakshmi, T P Rajagopal

Abstract

Flexible bronchoscopy (FB) is commonly performed by respiratory physicians for diagnostic as well as therapeutic purposes. However, bronchoscopy practices vary widely across India and worldwide. The three major respiratory organizations of the country supported a national-level expert group that formulated a comprehensive guideline document for FB based on a detailed appraisal of available evidence. These guidelines are an attempt to provide the bronchoscopist with the most scientifically sound as well as practical approach of bronchoscopy. It involved framing appropriate questions, review and critical appraisal of the relevant literature and reaching a recommendation by the expert groups. The guidelines cover major areas in basic bronchoscopy including (but not limited to), indications for procedure, patient preparation, various sampling procedures, bronchoscopy in the ICU setting, equipment care, and training issues. The target audience is respiratory physicians working in India and well as other parts of the world. It is hoped that this document would serve as a complete reference guide for all pulmonary physicians performing or desiring to learn the technique of flexible bronchoscopy.

Keywords: Bronchoscopy; Evidence-based medicine; Guidelines; Intensive care; Lung cancer; Tuberculosis.

Conflict of interest statement

None

Figures

Figure 1
Figure 1
Bronchoscope disinfection: This includes 3 steps - Cleaning, disinfection and storage or reuse. Cleaning consists of pre-cleaning to remove inorganic burden and visible soiling followed by leak testing to check for leaks in the sheath and proper cleaning which can be done either manually or in Automated endoscope reprocessor (AER). After rinsing, disinfection is performed either manually or in AER. Rinsing is repeated and is followed by drying and storage of the scope
Appendix 5
Appendix 5
The International Association for the Study of Lung Cancer Lymph Node map (ref [259])

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Source: PubMed

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