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ORIGINAL ARTICLE
Year : 2018  |  Volume : 35  |  Issue : 2  |  Page : 98-107

A survey of flexible bronchoscopy practices in India: The Indian bronchoscopy survey (2017)


1 Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
2 Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Dr. Karan Madan
Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/lungindia.lungindia_417_17

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Background: There is a lack of contemporaneous data on the practices of flexible bronchoscopy in India. Aim: The aim of the study was to study the prevalent practices of flexible bronchoscopy across India. Methods: The “Indian Bronchoscopy Survey” was a 98-question, online survey structured into the following sections: general information, patient preparation and monitoring, sedation and topical anesthesia, procedural/technical aspects, and bronchoscope disinfection/staff protection. Results: Responses from 669 bronchoscopists (mean age: 40.2 years, 91.8% adult pulmonologists) were available for analysis. Approximately, 70,000 flexible bronchoscopy examinations had been performed over the preceding year. A majority (59%) of bronchoscopists were performing bronchoscopy without sedation. A large number (45%) of bronchoscopists had learned the procedure outside of their fellowship training. About 55% used anticholinergic premedication either as a routine or occasionally. Nebulized lignocaine was being used by 72%, while 24% utilized transtracheal administration of lignocaine. The most commonly (75%) used concentration of lignocaine was 2%. Midazolam with or without fentanyl was the preferred agent for intravenous sedation. The use of video bronchoscope was common (80.8%). The most common (94%) route for performing bronchoscopy was nasal. Conventional transbronchial needle aspiration (TBNA) was being performed by 74%, while 92% and 78% performed endobronchial and transbronchial lung biopsy, respectively. Therapeutic airway interventions (stents, electrocautery, cryotherapy, and others) were being performed by 30%, while endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) and rigid bronchoscopy were performed by 27% and 19.5%, respectively. Conclusion: There is a wide national variation in the practices of performing flexible bronchoscopy. However, there has been a considerable improvement in bronchoscopy practices compared to previous national surveys.


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