Guidelines on analgosedation, monitoring, and recovery time for flexible bronchoscopy: a systematic review
| Autor: | Alberto Lopez-Pastorini, Nils Jurian Kosse, Erich Stoelben, Daniel Strohleit, Thomas Galetin |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Pulmonary and Respiratory Medicine medicine.medical_specialty Monitoring Midazolam Sedation Conscious Sedation MEDLINE Guidelines as Topic Guideline Hypercapnia Diseases of the respiratory system 03 medical and health sciences Patient safety 0302 clinical medicine Bronchoscopy medicine Humans 030212 general & internal medicine Intensive care medicine Recovery time RC705-779 medicine.diagnostic_test business.industry Carbon Dioxide Airway obstruction medicine.disease Analgesics Opioid Pulse oximetry 030228 respiratory system Capnometry Breathing medicine.symptom business Blood Gas Monitoring Transcutaneous Research Article |
| Zdroj: | BMC Pulmonary Medicine BMC Pulmonary Medicine, Vol 21, Iss 1, Pp 1-13 (2021) |
| ISSN: | 1471-2466 |
| Popis: | Background Patients undergoing bronchoscopy in spontaneous breathing are prone to hypoxaemia and hypercapnia. Sedation, airway obstruction, and lung diseases impair respiration and gas exchange. The restitution of normal respiration takes place in the recovery room. Nonetheless, there is no evidence on the necessary observation time. We systematically reviewed current guidelines on bronchoscopy regarding sedation, monitoring and recovery. Methods This review was registered at the PROSPERO database (CRD42020197476). MEDLINE and awmf.org were double-searched for official guidelines, recommendation or consensus statements on bronchoscopy from 2010 to 2020. The PICO-process focussed on adults (Patients), bronchoscopy with maintained spontaneous breathing (Interventions), and recommendations regarding the intra- and postprocedural monitoring and sedation (O). The guideline quality was graded. A catalogue of 54 questions was answered. Strength of recommendation and evidence levels were recorded for each recommendation. Results Six guidelines on general bronchoscopy and three expert statements on special bronchoscopic procedures were identified. Four guidelines were evidence-based. Most guidelines recommend sedation to improve the patient’s tolerance. Midazolam combined with an opioid is preferred. The standard monitoring consists of non-invasive blood pressure, and pulse oximetry, furthermore electrocardiogram in cardiac patients. Only one guideline discusses hypercapnia and capnometry, but without consensus. Two guidelines discuss a recovery time of two hours, but a recommendation was not given because of lack of evidence. Conclusion Evidence for most issues is low to moderate. Lung-diseased patients are not represented by current guidelines. Capnometry and recovery time lack evidence. More primary research in these fields is needed so that future guidelines may address these issues, too. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink