Bronchial thermoplasty for severe asthma: A position statement of the Indian chest society.
Anesthesia
bronchial asthma
bronchial thermoplasty
prednisolone
Journal
Lung India : official organ of Indian Chest Society
ISSN: 0970-2113
Titre abrégé: Lung India
Pays: India
ID NLM: 8405380
Informations de publication
Date de publication:
Historique:
entrez:
4
1
2020
pubmed:
4
1
2020
medline:
4
1
2020
Statut:
ppublish
Résumé
Bronchial thermoplasty (BT) is an interventional bronchoscopic treatment for severe asthma. There is a need to define patient selection criteria to guide clinicians in offering the appropriate treatment options to patients with severe asthma. An expert group formed this statement under the aegis of the Indian Chest Society. We performed a systematic search of the MEDLINE and EMBASE databases to extract evidence on patient selection and the technical performance of BT. The experts agreed that the appropriate selection of patients is crucial and proposed identification of the asthma phenotype, a screening algorithm, and inclusion/exclusion criteria for BT. In the presence of atypical clinical or chest radiograph features, there should be a low threshold for obtaining a thoracic computed tomography scan before BT. The patient should not have had an asthma exacerbation in the preceding two weeks from the day of the procedure. A 5-day course of glucocorticoid should be administered, beginning three days before the procedure day, and continued until the day following the procedure. General Anesthesia (total intravenous anesthesia with a neuromuscular blocker) provides ideal conditions for performing BT. A thin bronchoscope with a 2.0 mm working channel is preferable. An attempt should be made to deliver the maximum radiofrequency activations. Middle lobe treatment is not recommended. Following the procedure, overnight observation in the hospital, and a follow-up visit, a week following each treatment session, is desirable. This position statement provides practical guidance regarding patient selection and the technical performance of BT for severe asthma.
Identifiants
pubmed: 31898635
pii: LungIndia_2020_37_1_86_274428
doi: 10.4103/lungindia.lungindia_418_19
pmc: PMC6961101
doi:
Types de publication
Journal Article
Langues
eng
Pagination
86-96Déclaration de conflit d'intérêts
None
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