Bronchial thermoplasty for severe asthma: A position statement of the Indian chest society
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...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Lung India |
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| Online Access: | http://www.lungindia.com/article.asp?issn=0970-2113;year=2020;volume=37;issue=1;spage=86;epage=96;aulast=Madan |
| _version_ | 1818313880920653824 |
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| author | Karan Madan Saurabh Mittal Tejas M Suri Avinash Jain Anant Mohan Vijay Hadda Pavan Tiwari Randeep Guleria Deepak Talwar Sudhir Chaudhri Virendra Singh Rajesh Swarnakar Sachidanand J Bharti Rakesh Garg Nishkarsh Gupta Vinod Kumar Ritesh Agarwal Ashutosh N Aggarwal Irfan I Ayub Prashant N Chhajed Amit Dhamija Raja Dhar Sahajal Dhooria Hari K Gonuguntla Rajiv Goyal Parvaiz A Koul Raj Kumar Nagarjuna Maturu Ravindra M Mehta Ujjwal Parakh Vallandaramam Pattabhiraman Narasimhan Raghupathi Inderpaul Singh Sehgal Arjun Srinivasan Kavitha Venkatnarayan |
| author_facet | Karan Madan Saurabh Mittal Tejas M Suri Avinash Jain Anant Mohan Vijay Hadda Pavan Tiwari Randeep Guleria Deepak Talwar Sudhir Chaudhri Virendra Singh Rajesh Swarnakar Sachidanand J Bharti Rakesh Garg Nishkarsh Gupta Vinod Kumar Ritesh Agarwal Ashutosh N Aggarwal Irfan I Ayub Prashant N Chhajed Amit Dhamija Raja Dhar Sahajal Dhooria Hari K Gonuguntla Rajiv Goyal Parvaiz A Koul Raj Kumar Nagarjuna Maturu Ravindra M Mehta Ujjwal Parakh Vallandaramam Pattabhiraman Narasimhan Raghupathi Inderpaul Singh Sehgal Arjun Srinivasan Kavitha Venkatnarayan |
| author_sort | Karan Madan |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-13T08:40:47Z |
| format | Article |
| id | doaj.art-6483212911d841e78b0034f78a5a13fc |
| institution | Directory Open Access Journal |
| issn | 0970-2113 0974-598X |
| language | English |
| last_indexed | 2024-12-13T08:40:47Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Lung India |
| spelling | doaj.art-6483212911d841e78b0034f78a5a13fc2022-12-21T23:53:32ZengWolters Kluwer Medknow PublicationsLung India0970-21130974-598X2020-01-01371869610.4103/lungindia.lungindia_418_19Bronchial thermoplasty for severe asthma: A position statement of the Indian chest societyKaran MadanSaurabh MittalTejas M SuriAvinash JainAnant MohanVijay HaddaPavan TiwariRandeep GuleriaDeepak TalwarSudhir ChaudhriVirendra SinghRajesh SwarnakarSachidanand J BhartiRakesh GargNishkarsh GuptaVinod KumarRitesh AgarwalAshutosh N AggarwalIrfan I AyubPrashant N ChhajedAmit DhamijaRaja DharSahajal DhooriaHari K GonuguntlaRajiv GoyalParvaiz A KoulRaj KumarNagarjuna MaturuRavindra M MehtaUjjwal ParakhVallandaramam PattabhiramanNarasimhan RaghupathiInderpaul Singh SehgalArjun SrinivasanKavitha VenkatnarayanBronchial 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.http://www.lungindia.com/article.asp?issn=0970-2113;year=2020;volume=37;issue=1;spage=86;epage=96;aulast=Madananesthesiabronchial asthmabronchial thermoplastyprednisolone |
| spellingShingle | Karan Madan Saurabh Mittal Tejas M Suri Avinash Jain Anant Mohan Vijay Hadda Pavan Tiwari Randeep Guleria Deepak Talwar Sudhir Chaudhri Virendra Singh Rajesh Swarnakar Sachidanand J Bharti Rakesh Garg Nishkarsh Gupta Vinod Kumar Ritesh Agarwal Ashutosh N Aggarwal Irfan I Ayub Prashant N Chhajed Amit Dhamija Raja Dhar Sahajal Dhooria Hari K Gonuguntla Rajiv Goyal Parvaiz A Koul Raj Kumar Nagarjuna Maturu Ravindra M Mehta Ujjwal Parakh Vallandaramam Pattabhiraman Narasimhan Raghupathi Inderpaul Singh Sehgal Arjun Srinivasan Kavitha Venkatnarayan Bronchial thermoplasty for severe asthma: A position statement of the Indian chest society Lung India anesthesia bronchial asthma bronchial thermoplasty prednisolone |
| title | Bronchial thermoplasty for severe asthma: A position statement of the Indian chest society |
| title_full | Bronchial thermoplasty for severe asthma: A position statement of the Indian chest society |
| title_fullStr | Bronchial thermoplasty for severe asthma: A position statement of the Indian chest society |
| title_full_unstemmed | Bronchial thermoplasty for severe asthma: A position statement of the Indian chest society |
| title_short | Bronchial thermoplasty for severe asthma: A position statement of the Indian chest society |
| title_sort | bronchial thermoplasty for severe asthma a position statement of the indian chest society |
| topic | anesthesia bronchial asthma bronchial thermoplasty prednisolone |
| url | http://www.lungindia.com/article.asp?issn=0970-2113;year=2020;volume=37;issue=1;spage=86;epage=96;aulast=Madan |
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