Standardized Definitions of Bleeding After Transbronchial Lung Biopsy: A Delphi Consensus Statement From the Nashville Working Group.

Autor:	Folch EE; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA. Electronic address: efolch@mgh.harvard.edu., Mahajan AK; INOVA Medical Group, Falls Church, VA., Oberg CL; Division of Pulmonary, Critical Care Medicine, Clinical Immunology, and Allergy, David Geffen School of Medicine at UCLA, Los Angeles, CA., Maldonado F; Vanderbilt University Medical Center, Nashville, TN., Toloza E; Moffitt Cancer Center, Tampa, FL., Krimsky WS; MedStar Franklin Square Medical Center, Baltimore, MD., Oh S; Division of Pulmonary, Critical Care Medicine, Clinical Immunology, and Allergy, David Geffen School of Medicine at UCLA, Los Angeles, CA., Bowling MR; Division of Pulmonary, Critical Care, and Sleep Medicine, East Carolina University, Greenville, NC., Benzaquen S; University of Cincinnati, Cincinnati, OH., Kinsey CM; University of Vermont, Burlington, VT., Mehta AC; Cleveland Clinic Health System, Cleveland, OH., Fernandez-Bussy S; Mayo Clinic Hospital Jacksonville, Jacksonville, FL., Flandes J; Interventional Pulmonology Service, Hospital Universitario Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain., Lau K; Barts Health NHS Trust, London, England., Krishna G; Palo Alto Medical Foundation, Palo Alto, CA., Nead MA; University of Rochester, Rochester, NY., Herth F; Department of Pneumology and Critical Care Medicine, Thoraxklinik University of Heidelberg, Heidelberg, Germany., Aragaki-Nakahodo AA; University of Cincinnati, Cincinnati, OH., Barisione E; Interventional Pulmonology Unit, IRCCS San Martino Hospital-IST National Cancer Research Institute, Genoa, Italy., Bansal S; Lancaster General Hospital, Lancaster, PA., Zanchi D; Pulmonary and Sleep of Tampa Bay Inc, Wesley Chapel, FL., Zgoda M; University Pulmonary Associates, Charlotte, NC., Lutz PO; Pulmonary Associates of Mobile, Daphne, AL., Lentz RJ; Vanderbilt University Medical Center, Nashville, TN., Parks C; Cancer Treatment Centers of America, Atlanta, GA., Salio M; IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Perret K; Shannon Medical Center, San Angelo, TX., Keyes C; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA., LeMense GP; Blount Memorial Hospital, Maryville, TN., Hinze JD; Seton Healthcare Family, Austin, TX., Majid A; Division of Thoracic Surgery and Interventional Pulmonology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA., Christensen M; Rigshospitalet, Copenhagen, Denmark., Kazakov J; Brigham and Women's Hospital, Boston, MA., Labarca G; Department of Internal Medicine, Pontifical Catholic University, Santiago, Chile., Waller E; Blount Memorial Hospital, Maryville, TN., Studnicka M; Department of Pulmonary Medicine, the Paracelsus Medical University, Salzburg, Austria., Teba CV; University Hospitals of Cleveland, Cleveland, OH., Khandhar SJ; Virginia Cancer Specialists PC, Fairfax, VA.
Jazyk:	angličtina
Zdroj:	Chest [Chest] 2020 Jul; Vol. 158 (1), pp. 393-400. Date of Electronic Publication: 2020 Feb 14.
DOI:	10.1016/j.chest.2020.01.036
Abstrakt:	Background: Transbronchial lung biopsies are commonly performed for a variety of indications. Although generally well tolerated, complications such as bleeding do occur. Description of bleeding severity is crucial both clinically and in research trials; to date, there is no validated scale that is widely accepted for this purpose. Can a simple, reproducible tool for categorizing the severity of bleeding after transbronchial biopsy be created? Methods: Using the modified Delphi method, an international group of bronchoscopists sought to create a new scale tailored to assess bleeding severity among patients undergoing flexible bronchoscopy with transbronchial lung biopsies. Cessation criteria were specified a priori and included reaching > 80% consensus among the experts or three rounds, whichever occurred first. Results: Thirty-six expert bronchoscopists from eight countries, both in academic and community practice settings, participated in the creation of the scale. After the live meeting, two iterations were made. The second and final scale was vetted by all 36 participants, with a weighted average of 4.47/5; 53% were satisfied, and 47% were very satisfied. The panel reached a consensus and proposes the Nashville Bleeding Scale. Conclusions: The use of a simplified airway bleeding scale that can be applied at bedside is an important, necessary tool for categorizing the severity of bleeding. Uniformity in reporting clinically significant airway bleeding during bronchoscopic procedures will improve the quality of the information derived and could lead to standardization of management. In addition to transbronchial biopsies, this scale could also be applied to other bronchoscopic procedures, such as endobronchial biopsy or endobronchial ultrasound-guided needle aspiration. (Copyright © 2020. Published by Elsevier Inc.)
Databáze:	MEDLINE
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