Bronchial thermoplasty for severe asthma: A position statement of the Indian chest society
Year: 2019
Type: article
Abstract: 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. METHODOLOGY: 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. RESULTS: 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. CONCLUSION: This position statement provides practical guidance regarding patient selection and the technical performance of BT for severe asthma.
Source: Lung India
Authors: Karan Madan, Saurabh Mittal, TejasM Suri, Avinash Jain, Anant Mohan, Vijay Hadda, Pavan Tiwari, Randeep Guleria, Deepak Talwar, Sudhir Chaudhri, Virendra Singh, Rajesh Swarnakar, SachidanandJ Bharti, Rakesh Garg, Nishkarsh Gupta, Vinod Kumar, Ritesh Agarwal, AshutoshN Aggarwal, IrfanI Ayub, PrashantN Chhajed, Amit Dhamija, Raja Dhar, Sahajal Dhooria, HariK Gonuguntla, Rajiv Goyal, ParvaizA Koul, Raj Kumar, Nagarjuna Maturu, RavindraM Mehta, Ujjwal Parakh, Vallandaramam Pattabhiraman, Narasimhan Raghupathi, InderpaulSingh Sehgal, Arjun Srinivasan, Kavitha Venkatnarayan
Institutions: All India Institute of Medical Sciences, Ganesh Shankar Vidyarthi Memorial Medical College, Getwell Hospital and Research Institute, Post Graduate Institute of Medical Education and Research, Sri Ramachandra Medical Centre, Sir Ganga Ram Hospital, Fortis Hospital, Yashoda Hospital, Rajiv Gandhi Cancer Institute and Research Centre, Jaipur Golden Hospital, Sher-i-Kashmir Institute of Medical Sciences, University of Delhi, Apollo Hospitals, Apollo Hospitals, St.John's Medical College Hospital
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W3122029128