Survey of flexible bronchoscopy practice in adults in Saudi Arabia

Ahmed A. Aljohaney, Amr S. Albanna, Mohammed A. Alhajji, Abullah F. Mobeireek, Enas M. Batubara, Mohammed B. Zalt, Majed A. Alghamdi

Abstract


Objectives: To assess current adherence to international guidelines for practitioners of bronchoscopy in the Kingdom of Saudi Arabia.

 

Methods: A cross-sectional survey was conducted in Saudi Arabia between December 2016 and March 2017. Pulmonologists, thoracic surgeons, and intensivists were invited to answer an emailed self-administered questionnaire survey seeking information on how they performed flexible bronchoscopy in adults. The data collected were compared between the 3 specialties.

 

Results: Eighty-two (18%) of 456 invited practitioners completed the survey. Fifty-eight (72%) of the 82 respondents were pulmonologists. Forty (53%) of 76 respondents (93%) who had received bronchoscopy training received it abroad. Twenty-seven respondents (33%) had also received training in endobronchial ultrasound, electrocautery, brachytherapy, stent insertion, and laser procedures. Fifty-eight respondents (70%) preferred patients to undergo fasting for at least 4 hours before the procedure. Lidocaine was used for topical anesthesia, mainly by aerosol spray or nebulization. Midazolam was used by 62%, fentanyl by 50%, and propofol by 12% of respondents. Ninety percent of pulmonologists reported requesting a chest radiograph after transbronchial lung biopsy. Safety procedures for bronchoscopists, for example, wearing masks and eye protection, and for patients, for example, availability of anesthetic reversal agents, were not universally applied.

 

Conclusion: Bronchoscopy is not standardized in Saudi Arabia. National guidelines for the indications and practice of bronchoscopy are required.

Saudi Med J 2019; Vol. 40 (3): 238-245
doi: 10.15537/smj.2019.3.23964

How to cite this article:
Aljohaney AA, Albanna AS, Alhajji MA, Mobeireek AF, Batubara EM, Zalt MB, et al. Survey of flexible bronchoscopy practice in adults in Saudi Arabia. Saudi Med J. 2019 Mar;40(3):238-245. doi: 10.15537/smj.2019.3.23964. 


Keywords


flexible bronchoscopy; Saudi Arabia; adults; guidelines

Full Text:

PDF HTML

References


Ikeda S, Yanai N, Ishikawa S. Flexible bronchofiberscope. Keio J Med 1968; 17: 1-16.

Prakash U, Offord KP. Stubbs SE. Bronchoscopy in North America: the ACCP survey. Chest 1991; 100: 1668-1675.

Pierce CW, Gjevre JA, Taylor-Gjevre RM. A survey of current bronchoscopy practices in Canada: a dearth of evidence or evidence-based practice? Chest 2011; 140: 833-834.

Madkour A, Al Halfawy A, Sharkawy S, Zakzouk Z. Survey of adult flexible bronchoscopy practice in Cairo. J Bronchol 2008; 15: 27-32.

Pyng L, Loo CM, Jagadesan R, Colt HG. Survey of bronchoscopy practice in Singapore. J Bronchol 2008; 15: 215-220.

Smyth CM, Stead RJ. Survey of flexible fibreoptic bronchoscopy in the United Kingdom. Eur Respir J 2002; 19: 458-463.

Facciolongo N, Piro R, Menzella F, Lusuardi M, Salio M, Agli LL, et al. Training and practice in bronchoscopy a national survey in Italy. Monaldi Arch Chest Dis 2013; 79: 128-133.

Hautmann H, Hetzel J, Eberhardt R, Stanzel F, Wagner M, Schneider A, et al. Cross-sectional survey on bronchoscopy in Germany--the current status of clinical practice. Pneumologie 2016; 70: 110-116.

Asano F, Aoe M, Ohsaki Y, Okada Y, Sasada S, Sato S, et al. Bronchoscopic practice in Japan: a survey by the Japan Society for Respiratory Endoscopy in 2010. Respirology 2013; 18: 284-290.

Barnett AM, Jones R, Simpson G. A survey of bronchoscopy practice in Australia and New Zealand. J Bronchology Interv Pulmonol 2016; 23: 22-28.

Madan K, Mohan A, Agarwal R, Hadda V, Khilnani GC, Guleria R. A survey of flexible bronchoscopy practices in India: The Indian bronchoscopy survey (2017). Lung India 2018; 35: 98-107.

Du Rand IA, Blaikley J, Booton R, Chaudhuri N, Gupta V, Khalid S, et al. British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE. Thorax 2013; 68: i1-i44.

Ernst A, Wahidi MM, Read CA, Buckley JD, Addrizzo-Harris DJ, Shah PL, et al. Adult bronchoscopy training: current state and suggestions for the future: CHEST Expert Panel Report. Chest 2015; 148: 321-332.

Wahidi MM, Jain P, Jantz M, Lee P, Mackensen GB, Barbour SY, et al. American College of Chest Physicians consensus statement on the use of topical anesthesia, analgesia, and sedation during flexible bronchoscopy in adult patients. Chest 2011; 140: 1342-1350.

Alamoudi OS, Attar SM, Ghabrah TM, Kassimi MA. Bronchoscopy, indications, safety and complications. Saudi Med J 2000; 21: 1043-1047.

Bolliger CT, Mathur PN, Beamis JF, Becker HD, Cavaliere S, Colt H, et al. ERS/ATS statement on interventional pulmonology. European Respiratory Society/American Thoracic Society. Eur Respir J 2002; 19: 356-373.

Fielding D, Phillips M, Robinson P, Irving L, Garske L, Hopkins P, et al. Advanced interventional pulmonology procedures: training guidelines from the Thoracic Society of Australia and New Zealand. Respirology 2012; 17: 1176-1189.

Madan NK, Madan K, Jain D, Walia R, Mohan A, Hadda V, et al. Utility of conventional transbronchial needle aspiration with rapid on-site evaluation (c-TBNA-ROSE) at a tertiary care center with endobronchial ultrasound (EBUS) facility. J Cytol 2016; 33: 22-26.

Kaur H, Dhooria S, Aggarwal AN, Gupta D, Behera D, Agarwal R. A randomized trial of 1% vs 2% lignocaine by the spray as you go technique for topical anesthesia during flexible bronchoscopy. Chest 2015; 148: 739-745.

Madan K, Biswal SK, Mittal S, Hadda V, Mohan A, Khilnani GC, et al. 1% versus 2% lignocaine for airway anesthesia in flexible bronchoscopy without lignocaine nebulization (LIFE): a randomized controlled trial. J Bronchology Interv Pulmonol 2018; 25: 103-110.

Heuss LT, Froehlich F, Beglinger C. Changing patterns of sedation and monitoring practice during endoscopy: results of a nationwide survey in Switzerland. Endoscopy 2005; 37: 161-166.

Rhee CK, Kang HH, Kang JY, Kim JW, Kim YH, Park SA, et al. Diagnostic yield of flexible bronchoscopy without fluoroscopic guidance in evaluating peripheral lung lesions. J Bronchology Interv Pulmonol 2010; 17: 317-32.


Refbacks

  • There are currently no refbacks.




Saudi Medical Journal is copyright under the Berne Convention and the International Copyright Convention.  Saudi Medical Journal is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work. Electronic ISSN 1658-3175. Print ISSN 0379-5284.