Open AccessFlexible bronchoscopy during the COVID-19 pandemic: A concise clinical review and practical recommendations
Author(s) -
Girish Sindhwani,
Mayank Mishra,
Mihir Gangakhedkar,
Karan Madan,
Ruchi Dua,
Prakhar Sharma,
Lokesh Kumar Saini
Publication year - 2021
Publication title -
lung india
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 25
eISSN - 0974-598X
pISSN - 0970-2113
DOI - 10.4103/lungindia.lungindia_357_20
Subject(s) - bronchoscopy , medicine , covid-19 , pulmonology , pandemic , suspect , flexible bronchoscopy , intensive care medicine , transmission (telecommunications) , medical emergency , clinical practice , surgery , pathology , family medicine , disease , infectious disease (medical specialty) , computer science , telecommunications , outbreak , political science , law
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.