Single-Use (Disposable) Flexible Bronchoscopes: The Future of Bronchoscopy?
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REVIEW
Single-Use (Disposable) Flexible Bronchoscopes: The Future of Bronchoscopy? Sarah P. Barron . Marcus P. Kennedy
Received: June 8, 2020 / Accepted: September 3, 2020 Ó The Author(s) 2020
ABSTRACT The coronavirus disease (COVID-19) pandemic has highlighted the importance of reducing occupational exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The reprocessing procedure for reusable flexible bronchoscopes (RFBs) involves multiple episodes of handling of equipment that has been used during an aerosol-generating procedure and thus is a potential source of transmission. Single-use flexible bronchoscopes (SUFBs) eliminate this source. Additionally, RFBs pose a risk of nosocomial infection transmission between patients with the identification of human proteins, deoxyribonucleic acid (DNA) and pathogenic organisms on fully reprocessed bronchoscopes despite full adherence to the guidelines. Bronchoscopy units have been hugely impacted by the pandemic with restructuring of pre- and post-operative areas, altered patient protocols and the reassessment of air exchange and cleaning procedures. SUFBs can be incorporated into these protocols as a means of improving occupational safety. Most studies on the efficacy of SUFBs have occurred in an
anaesthetic setting so it remains to be seen whether they will perform to an acceptable standard in complex respiratory procedures such as transbronchial biopsies and cryotherapy. Here, we outline their potential uses in a respiratory setting, both during and after the current pandemic.
Keywords: COVID-19; Disposable bronchoscope; Single-use flexible bronchoscope; Pandemic; SARS-CoV-2 Key Summary Points Bronchoscopy is an aerosol-generating procedure and associated with a high risk of viral transmission during the COVID19 pandemic Single-use flexible bronchoscopes (SUFBs) can reduce the number of healthcare personnel exposed to SARS-CoV-2 SUFBs have many advantages over their reusable counterparts
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12905990.
Most of the studies on SUFB efficacy and cost-effectiveness have been in an anaesthetic setting
S. P. Barron M. P. Kennedy (&) Department of Respiratory Medicine, Cork University Hospital, Wilton, Cork, Republic of Ireland e-mail: [email protected]
We outline the benefits of SUFBs during the COVID-19 pandemic and provide a rationale for their more frequent use in the pulmonology suite
Adv Ther
DIGITAL FEATURES This article is published with digital features to facilitate understanding of the article. To view digital features for this article go to https://doi. org/10.6084/m9.figshare.12905990.
INTRODUCTION The development of reusable flexible bronchoscopes (RFBs) in 1968 was a ground-breaking development in diagnostic and therapeutic bronchoscopy. Common indications include diagnostic washings, endobronchial biopsy and brushings and transbronchial needle aspiration (TBNA). Many therapeutic procedures are now possible with both rigid and fle
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