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Correspondence |

Bronchoscopy in China: The Chinese Society of Respiratory Diseases Survey FREE TO VIEW

Xiaomeng Nie, MD; Gang Cai, MD; Qiang Li, MD
Author and Funding Information

Affiliations: Drs. Nie, Cai, and Li are affiliated with the Second Military Medical University.

Correspondence to: Qiang Li, MD, Department of Respiratory Diseases, Changhai Hospital, the Second Military Medical University, 168 Changhai Rd, Shanghai 200433, People's Republic of China; e-mail: liq524@yahoo.com.cn


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(4):1186-1187. doi:10.1378/chest.09-1402
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In order to investigate the clinical application of bronchoscopy in China, the Chinese Society of Respiratory Diseases conducted a retrospective survey in 2008. Questionnaires were sent to 40 hospitals of the Chinese Society of Respiratory Diseases in 24 provinces of China to investigate bronchoscopic procedures during 2007. They were completed and returned from 30 hospitals (75%) in 21 provinces. The following results were determined by the statistics reported in these questionnaires.

All of the hospitals possessed flexible bronchoscopes, but only seven hospital possessed rigid bronchoscopes. All of the hospitals required that patients sign informed consent forms before undergoing bronchoscopy. All of the hospitals performed a radiograph or CT scan before performing bronchoscopy. Twenty-four hospitals performed ECG, 23 hospitals examined coagulation profiles, 21 hospitals performed a CBC count, 16 hospitals examined hepatitis B markers, and 8 hospitals tested for HIV before the patient underwent bronchoscopy. Atropine was administered by 19 hospitals. Sedatives were administered by four hospitals, three of which also used atropine. Ten hospitals used no premedication. Nineteen hospitals performed bronchoscopy with all patients receiving topical anesthesia. Eleven hospitals performed bronchoscopy with most patients receiving topical anesthesia, and a few patients receiving general anesthesia. For topical anesthesia, 12 hospitals used a nebulizer, 8 hospitals used a spray, and 8 hospitals used both. The other two hospitals injected lidocaine through the bronchoscope over the glottis. An emergency cart was available in the examination room in 28 hospitals. During bronchoscopy, pulse oximetry was the most widely used monitoring method; some hospitals also monitored ECG and BP. Most hospitals used the nasal route to perform routine bronchoscopy. Some hospitals used the oral route for patients with a narrow nasal cavity. Twenty-three hospitals used a sink to wash the bronchoscopes, and 27 hospitals used glutaraldehyde to disinfect them.

The total number of flexible bronchoscopic procedures performed by the 30 hospitals during 2007 was 39,253, and the average number of procedures was 1,308 for one hospital. Diagnostic bronchoscopic procedures included brush and forceps biopsy, transbronchial lung biopsy, BAL, and transbronchial needle aspiration. They were more widely used than therapeutic bronchoscopy. Table 1 shows the number of therapeutic flexible bronchoscopic procedures performed. The use of airway stents by bronchoscopists (15.3%) was similar to the corresponding figure in the United Kingdom,1 lower than that in Japan (32%),2 while higher than that found in a survey by the American College of Chest Physicians (4.6%).3 Among complications, bleeding occurred most frequently. Most bleeding occurred during brush and forceps biopsies. The death rate was 0.076%. Although the number of hospitals in the survey was relatively small, this was the first nationwide survey on bronchoscopy undertaken in the People's Republic of China.

Table Graphic Jump Location
Table 1 Total Number of Therapeutic Flexible Bronchoscopic Procedures Performed in 2007

Financial/nonfinancial disclosures: The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Niwa H, Tanahashi M, Kondo T, et al. Bronchoscopy in Japan: a survey by the Japan Society for Respiratory Endoscopy in 2006. Respirology. 2009;14:282-289. [PubMed] [CrossRef]
 
Smyth CM, Stead RJ. Survey of flexible fibreoptic bronchoscopy in the United Kingdom. Eur Respir J. 2002;19:458-463. [PubMed]
 
Prakash UBS, Offord KP, Stubbs SE. Bronchoscopy in North America: the ACCP survey. Chest. 1991;100:1668-1675. [PubMed]
 

Figures

Tables

Table Graphic Jump Location
Table 1 Total Number of Therapeutic Flexible Bronchoscopic Procedures Performed in 2007

References

Niwa H, Tanahashi M, Kondo T, et al. Bronchoscopy in Japan: a survey by the Japan Society for Respiratory Endoscopy in 2006. Respirology. 2009;14:282-289. [PubMed] [CrossRef]
 
Smyth CM, Stead RJ. Survey of flexible fibreoptic bronchoscopy in the United Kingdom. Eur Respir J. 2002;19:458-463. [PubMed]
 
Prakash UBS, Offord KP, Stubbs SE. Bronchoscopy in North America: the ACCP survey. Chest. 1991;100:1668-1675. [PubMed]
 
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