Pre- and post-COVID practice of interventional pulmonology in adults in Portugal

IF 10.4 2区医学 Q1 RESPIRATORY SYSTEM

Pulmonology Pub Date : 2024-11-01 DOI:10.1016/j.pulmoe.2022.02.009

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引用次数: 0

Abstract

Introduction and objectives

There is a lack of information regarding bronchoscopy practice in adults in Portugal. Our objective was to obtain an overview of the characteristics, resources, techniques and behaviors in national interventional pulmonology (IP) units, before and after SARS-CoV-2 outbreak.

Materials and Methods

An online survey was developed by an expert panel with a total of 46 questions comprising the specifications of each unit, namely physical space, equipment, staff, procedure planning, monitoring, technical differentiation, and numbers pre- and post-COVID-19. Forty-one interventional pulmonology centers were invited to participate between April and May 2021.

Results

37 units (90.2%) responded to the survey. The majority (64.9%) have a fully dedicated space with a weekly presence of ≥3 chest physicians (82.1%) and support of an anesthesiologist on specific days (48.6%). There is marked heterogeneity in the IP unit's equipment, and 56.8% acquired disposable bronchoscopes after COVID-19 pandemics. Pre-bronchoscopy hemogram, platelet count and coagulation tests are regularly asked by more than 90% of the units, even when deep sedation or biopsies are not planned. In 97.3% of cases, topical anesthesia and midazolam are utilized. Propofol (21.6%) and fentanyl (29.7%) are occasionally employed in some institutions. Most units use ancillary sampling techniques to diagnose central or peripheral lesions, with radial EBUS being used for guidance of distal procedures in 37.8% of centers, linear EBUS and EUS-B-FNA for mediastinal diagnosis and/or staging in 45.9% and 27.0% of units, respectively. Cryobiopsies are used by 21.6% of respondents to diagnose diffuse lung diseases. Rigid bronchoscopy is performed in 37.8% of centers. There was a decrease in the number of flexible (p < 0.001) and rigid (p = 0.005) bronchoscopies and an upscale of personal protective equipment (PPE) during the COVID-19 outbreak.

Conclusions

IP units have variable bronchoscopic practices, but during the COVID-19 pandemic, they complied with most international recommendations, as elective procedures were postponed and PPE levels increased.

查看原文本刊更多论文

葡萄牙成人介入性肺病诊疗在 COVID 之前和之后的实践。

引言和目的：葡萄牙缺乏成人支气管镜检查方面的信息。我们的目标是在SARS-CoV-2疫情爆发前后，对国家介入肺科（IP）单位的特点、资源、技术和行为进行全面了解：专家小组编制了一份在线调查表，共有 46 个问题，包括每个科室的具体情况，即物理空间、设备、人员、手术计划、监测、技术差异以及 COVID-19 前后的人数。41 家介入肺科中心应邀在 2021 年 4 月至 5 月间参与了此次调查：37个单位（90.2%）对调查做出了回应。大多数单位（64.9%）拥有完全专用的空间，每周有≥3 名胸科医生（82.1%）在场，并在特定日期有麻醉师（48.6%）提供支持。IP 单位的设备存在明显差异，56.8% 在 COVID-19 大流行后购置了一次性支气管镜。90% 以上的科室会定期要求进行支气管镜检查前的血液造影、血小板计数和凝血功能检查，即使不计划进行深度镇静或活检。97.3%的病例使用局部麻醉和咪达唑仑。一些机构偶尔会使用丙泊酚（21.6%）和芬太尼（29.7%）。大多数单位使用辅助取样技术诊断中央或周边病变，37.8% 的中心使用径向 EBUS 引导远端手术，45.9% 和 27.0% 的单位分别使用线性 EBUS 和 EUS-B-FNA 进行纵隔诊断和/或分期。21.6%的受访者使用冷冻活组织检查诊断弥漫性肺部疾病。37.8%的中心进行硬支气管镜检查。柔性支气管镜检查的数量有所减少（P 结论）：IP 单位的支气管镜检查方法不尽相同，但在 COVID-19 大流行期间，它们遵守了大多数国际建议，推迟了选择性手术，并提高了个人防护设备水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pulmonology Medicine-Pulmonary and Respiratory Medicine

CiteScore

14.30

自引率

5.10%

发文量

159

审稿时长

19 days

期刊介绍： Pulmonology (previously Revista Portuguesa de Pneumologia) is the official journal of the Portuguese Society of Pulmonology (Sociedade Portuguesa de Pneumologia/SPP). The journal publishes 6 issues per year and focuses on respiratory system diseases in adults and clinical research. It accepts various types of articles including peer-reviewed original articles, review articles, editorials, and opinion articles. The journal is published in English and is freely accessible through its website, as well as Medline and other databases. It is indexed in Science Citation Index Expanded, Journal of Citation Reports, Index Medicus/MEDLINE, Scopus, and EMBASE/Excerpta Medica.