Recommendations for Bronchoscopy in Pediatric Patients in the COVID-19 Pandemic
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Abstract
Introduction: a bronchoscopy is a fundamental tool in respiratory clinical conditions, but it can be a source of transmission of infectious agents such as SARS-COV-2. Therefore, it is urgent to adopt international recommendations for our environment. In this study, we need indications, contraindications, and biosafety measures to perform bronchoscopy in patients with SARS-COV-2 infection.
Methods: the first phase consists of an analysis of the state of scientific research with a source of exploration on an academic basis. Subsequently, the elaboration of questions with the PICO methodology, using the PRISMA strategy. These were voted on by 18 Pediatric Bronchoscopist Pulmonologists who answered a survey and defined the agreement strength as strong, moderate and weak, based on expert agreement.
Results: the indications with the highest level of an agreement are suspicion of foreign body aspiration and massive hemoptysis. The contraindications with the highest level of an agreement are non-urgent conditions, thermoplasty, stent placement. The general recommendations with the highest degree of agreement are a notification to the anesthesiologist and surgical team. The recommendations during and after the procedure are to use personal protective equipment, proper removal of it, and disinfection of equipment with 75% alcohol.
Conclusions: bronchoscopy is a procedure inherent to critical care areas, the high training of the personnel assigned to these tasks is a fundamental principle for the success of its execution. Our project reaches a high level of agreement among the participating experts, which allows the elaboration of the Mexican Bronchoscopy Consensus.
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