Adult Interventional Pulmonary Practice in Portugal Before and After COVID

Journal of Pulmonology

Basics

With the advancement of technologies and methods, bronchoscopy and interventional pulmonary medicine (IP) have undergone tremendous change in recent years. Despite the fact that there are numerous guidelines from international associations and institutions, the majority are recommendations made by subject-matter experts who are more concerned with safety and practical considerations than with solid scientific evidence, so procedures are typically not standardized. In order to assess the availability of resources, the clinical application of techniques, and their specifics, numerous nations conducted national surveys. This was done in light of the current variety of procedures and the little knowledge about bronchoscopy practices. The usage of pleuroscopy in Portuguese pulmonology departments was evaluated explicitly in a national study that took into account accessibility, experts' training and experience, the number of procedures, and the procedure's characteristics. The Portuguese Pulmonology Society recently produced a consensus statement on patient, doctor, and other health professional safety during bronchoscopy and pleural operations in response to the Coronavirus Disease 2019 (COVID-19) pandemic outbreak.

As a result, specific precautions must be taken, including organizational issues, physical space, material preparation, and personal protection equipment (PPE) for all professionals involved. Based on current knowledge, it should be assumed that all patients are potentially infected with the severe acute respiratory syndrome Coronavirus-2. The Committee on Endoscopic Techniques of the Portuguese Pulmonology Society designated a working group to carry out a national survey in order to accurately characterize the Portuguese landscape because it was anticipated that these recent developments in the field of bronchology would have a significant impact on national interventional pulmonology units. With regard to the Portuguese Pulmonology Departments’ technological and human resources, the particulars of the bronchoscopy operations carried out, and a comparison of the situation before and after the COVID-19 pandemic, this survey's objectives were more focused.

Monitoring, Sedation, Anesthesia, and Patient Preparation

The majority of participants said that when the primary goal is to examine the airways and collect samples without the need for biopsies, they often request at least one pre-procedural evaluation to assess each patient who would be subjected to a standard flexible bronchoscopy.

Features of  Bronchoscopy Technology

Broncho alveolar lavage was found to be the best treatment option for diffuse lung disorders. Eight sites reported doing Trans bronchial lung cry biopsies, whereas the participants underwent Tran’s bronchial forceps biopsies. Seven centers utilized fluoroscopy to direct supplementary procedures for the identification of diffuse lung disorders. No centers did not report bronchoscopy lung volume reduction (with one-way valves, coils, or thermal ablation) and other end bronchial therapeutic techniques such as bronchial thermoplastic. 

Hypothesis

The current survey evaluated current patterns and COVID-19's effects on bronchoscopy procedures in Portugal. As with other questionnaires, it doesn't offer any suggestions or IP guidelines. It implies that the country's IP units have a variety of traits and actions, but throughout the COVID-19 pandemic, they adhered to the majority of international recommendations as elective procedures were delayed and PPE levels rose. Practice in the field of bronchoscopy was formerly governed by personal experience and the quirks of a specific unit, as new members would imitate and adopt the attitudes of more experienced practitioners. It is now necessary to improve IP physicians' training and competence maintenance across the nation in addition to standardizing practice. With the creation of a future national database, uniformity of practices and norms, and even better planning and organization of training programs, the current study helps to understand the situation and may lay the groundwork for improving the IP area in Portugal.

Journal Information

Journal of Pulmonology, an official publication of the Pulsus group, is a peer-reviewed, open-access journal in the respiratory research fraternity facilitating real-time peer-reviewed information on the subject. 

We accept articles across the discipline but are not limited to:

Asthma, Bronchiectasis, Bronchitis, Chronic Obstructive Pulmonary Disease (COPD), Chronic Hypercapnic respiratory failure (CHRF), Emphysema, Interstitial Lung Diseases, Lung Cancer, Obstructive Sleep Apnea, Pleural Effusion, Pneumoconiosis, Pneumonia, ARDS (acute respiratory distress syndrome), Cystic Fibrosis, Solitary Pulmonary Nodule, Tuberculosis.

Scope Categories

  • Bronchitis
  • Carcinom
  • Emphysema
  • Pulmonology
  • Epidemiology
  • Lung Diseases
  • Cystic Fibrosis
  • Respiratory Care
  • Pathophysiology
  • Thoracic Surgery
  • Pulmonary Edema

Publishes current research articles related to Pulmonary.

Manuscript Submission link: https://www.pulsus.com/submissions/pulmonology.html


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