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A survey of Pediatric Flexible bronchoscopy in India
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  • Kana Jat,
  • Sheetal Agarwal,
  • RAKESH LODHA,
  • Sushil Kabra
Kana Jat
All India Institute of Medical Sciences

Corresponding Author:drkanaram@gmail.com

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Sheetal Agarwal
All India Institute of Medical Sciences
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RAKESH LODHA
AIIMS
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Sushil Kabra
All India Institute of Medical Sciences
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Abstract

Background: Pediatric bronchoscopy is an important tool in pediatric pulmonology. However, the practices involved in the procedure are variable. Objective: To evaluate prevalent practice and variations in pediatric flexible bronchoscopy in India. Methods: An online survey conducted between September 2018 to March 2019 via Google forms. The survey was sent to members of the Respiratory Chapter of IAP, personal contacts, and members of Indian Chest Society. Physicians performing flexible bronchoscopy in children were asked to respond. Survey had 95 questions in seven domains including patient preparation, sedation, procedural aspects, monitoring, bronchoscope cleaning, and complications. Results: The survey received 24 (14 in private sector) complete responses from 14 cities. Pediatric bronchoscopy was mainly done for diagnostic purposes. Conscious sedation was used by most (19, 79%). Midazolam plus fentanyl 9 (37.5%) was the preferred sedation regimen. Routine atropine was used by 4 (16%). For topical anaesthesia- nebulized only, both nebulized and spray as go, and spray as go lignocaine only was used by 1 (4.2%), 6 (25%), and 17 (71%) centres, respectively. The methods of providing oxygen during bronchoscopy were free flow (9,37.5%), nasal prongs (8,33.3%), mask (6,25%), and LMA (1,4.2%). Therapeutic procedures included removal of mucus plugs (17, 71%), bronchoscopic intubation (11, 45%) and foreign body removal (10, 41%). The suction for BAL included wall mounted suction in maximum (15, 62.5%). The number of aliquots for BAL varied from 2-6 and volume for each aliquot also varied (1-2 ml/kg or 5-10 ml). The complications rate of less than 5 % was reported by almost all. Conclusion: There is large variation in pediatric flexible bronchoscopy practices across the country highlighting the need to develop a uniform guideline.
28 Jan 2022Submitted to Pediatric Pulmonology
31 Jan 2022Submission Checks Completed
31 Jan 2022Assigned to Editor
02 Feb 2022Reviewer(s) Assigned
09 Mar 2022Review(s) Completed, Editorial Evaluation Pending
08 Apr 2022Editorial Decision: Revise Major
08 May 20221st Revision Received
09 May 2022Submission Checks Completed
09 May 2022Assigned to Editor
09 May 2022Reviewer(s) Assigned
30 May 2022Review(s) Completed, Editorial Evaluation Pending
01 Jun 2022Editorial Decision: Revise Minor
17 Jul 20222nd Revision Received
20 Jul 2022Submission Checks Completed
20 Jul 2022Assigned to Editor
20 Jul 2022Reviewer(s) Assigned
20 Jul 2022Review(s) Completed, Editorial Evaluation Pending
21 Jul 2022Editorial Decision: Accept
Nov 2022Published in Pediatric Pulmonology volume 57 issue 11 on pages 2674-2680. 10.1002/ppul.26081