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The following is a summary of “Pre- and post-COVID practice of interventional pulmonology in adults in Portugal,” published in the November 2024 issue of Pulmonology by Guedes et al. 

Researchers conducted a retrospective study to analyze the characteristics, resources, techniques, and behaviors in national interventional pulmonology (IP) units before and after the SARS-CoV-2 outbreak.  

They created an online survey consisting of 46 questions, which addressed the specifications of each IP unit, including physical space, equipment, staff, procedure planning, monitoring, technical differentiation, and activity levels pre- and post-COVID-19, 41 IP centers were invited to participate between April and May 2021.  

The results showed that 37 units (90.2%) responded to the survey. The majority (64.9%) had a fully dedicated space with ≥3 chest physicians present weekly (82.1%) and anesthesiologist support on specific days (48.6%). The equipment varied significantly across units, and 56.8% acquired disposable bronchoscopes after the COVID-19 pandemic. Over 90% of units regularly requested pre-bronchoscopy hemogram, platelet count, and coagulation tests, regardless of sedation or biopsy plans. Topical anesthesia and midazolam were used in 97.3% of cases, while propofol (21.6%) and fentanyl (29.7%) were occasionally used. Most units employed ancillary techniques for diagnosing lesions, with radial Endobronchial Ultrasonography (EBUS) used in 37.8% of centers for distal guidance, linear EBUS in 45.9%, and EUS-B-FNA in 27.0% for mediastinal diagnosis/staging. Cryobiopsies were used in 21.6% of centers, and rigid bronchoscopy in 37.8%. A decrease in flexible (P < 0.001) and rigid bronchoscopies (P = 0.005) was noted, while personal protective equipment (PPE) use increased during the COVID-19 outbreak.  

Investigators concluded that while IP units exhibited variability in bronchoscopic practices during the COVID-19 pandemic, they generally adhered to international recommendations by postponing elective procedures and implementing stringent PPE measures. 

Source: sciencedirect.com/science/article/pii/S2531043722000708