Pleural disease & pleuropulmonary procedures

What’s inside

This guideline offers comprehensive recommendations for the investigation and management of pleural diseases in adults, covering areas such as spontaneous pneumothorax, undiagnosed unilateral pleural effusion, pleural infection, and pleural malignancy.

Why it’s relevant

It provides evidence-based guidance to healthcare professionals, aiming to standardize and enhance the care of patients with pleural diseases, thereby improving patient outcomes.

Key focus

• Spontaneous pneumothorax: Management strategies including conservative treatment, ambulatory care, and surgical options.
• Pleural effusion: Diagnostic approaches and therapeutic interventions for undiagnosed unilateral pleural effusions.
• Pleural infection: Recommendations on the assessment and treatment of pleural infections.
• Pleural malignancy: Guidance on the diagnosis and management of malignant pleural diseases.

Takeaway

Implementing these guidelines can lead to more effective and standardized management of pleural diseases, improving patient care and outcomes.

What’s inside

This clinical statement provides detailed guidance on pleural interventions in adults, complementing the British Thoracic Society (BTS) Guideline for Pleural Disease 2023. It covers safety protocols, patient selection, complication rates, consent processes, and troubleshooting for various pleural procedures.

Why it’s relevant

It offers evidence-based recommendations to healthcare professionals, aiming to standardize and enhance the safety and effectiveness of pleural procedures, thereby improving patient outcomes.

Key focus

• Safety and preparation for pleural procedures.
• Pleural aspiration (diagnostic and therapeutic).
• Intercostal drain insertion.
• Indwelling pleural catheter (IPC) insertion, management, and removal.
• Image-guided pleural biopsy.
• Medical thoracoscopy.

Additionally, the statement includes supplemental appendices with practical "how-to" guides on topics such as local anesthesia for pleural procedures, sample consent forms, and techniques for various interventions.

Takeaway

Adhering to these guidelines can lead to safer and more effective pleural interventions, standardizing care practices and improving patient outcomes in clinical settings.

What’s inside

This guideline provides comprehensive recommendations for the safe and effective use of diagnostic flexible bronchoscopy in adults, covering patient preparation, procedural techniques, and post-procedure care.

Why it’s relevant

It offers evidence-based guidance to healthcare professionals, aiming to standardize bronchoscopy practices, enhance diagnostic accuracy, and minimize complications.

Key focus

• Patient preparation: Assessment of fitness for bronchoscopy, including evaluation of comorbidities and optimization of medical conditions.
• Sedation and monitoring: Recommendations on sedation protocols, continuous monitoring of vital signs, and management of potential hypoxemia during the procedure.
• Infection control: Guidelines on sterilization of equipment and prevention of cross-contamination.
• Sampling techniques: Best practices for obtaining biopsies, brushings, and lavage samples to maximize diagnostic yield.
• Complication management: Strategies for recognizing and managing complications such as bleeding, pneumothorax, and cardiac arrhythmias.

Takeaway

Adhering to these guidelines can improve the safety and diagnostic effectiveness of flexible bronchoscopy in adults, leading to better patient outcomes and standardized care practices.

What’s inside

This article discusses the increasing use of flexible bronchoscopy in critical care and anaesthesia, highlighting its role in examining, diagnosing, and managing critically ill patients.

Why it’s relevant

It provides insights into the applications of bronchoscopy in the intensive care unit (ICU), emphasizing its importance as a standard of care for airway management and therapeutic interventions.

Key focus

• Diagnostic applications: Utilization of bronchoscopy for inspecting airways, obtaining samples, and diagnosing conditions in critically ill patients.
• Therapeutic interventions: Use in procedures such as secretion removal, foreign body extraction, and management of airway obstructions.
• Safety and training: Emphasis on the need for proper training and adherence to safety protocols to minimize risks associated with bronchoscopy in the ICU.

Takeaway

Understanding the applications and considerations of bronchoscopy in critical care settings enhances patient management and supports its effective use as a diagnostic and therapeutic tool.