Chinese consensus statement on standard procedure and perioperative management of bronchial thermoplasty

Lin, Jiangtao; Nong, Ying; Yang, Dong; Li, Shiyue; Wang, Guangfa; Su, Nan; Zhong, Nanshan

doi:10.21037/jtd.2017.12.25

Cited by 5 publications

(6 citation statements)

References 16 publications

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“…The target temperature is 65 ℃ for 10 seconds. By heating the bronchial wall, the ASM cells keep a persistent reduction in quantity, thereby reducing the extent of airway contraction during asthma attacks and reducing the frequency and severity of asthma attacks (19).…”

Section: Operating Procedures and Its Principlesmentioning

confidence: 99%

“…The indications approved by CFDA for BT in treating asthma are severe persistent asthma patients over 18 years old who remain symptomatic despite adequate treatment of high-dose ICS and LABA. The contraindications include: (I) absolute contraindications: (i) patients with implanted pacemakers, defibrillators, or other electronic devices; (ii) patients with acute myocardial infarction within 6 weeks; (iii) Patients with the severe cardiopulmonary disease who cannot tolerate bronchoscopy; (iv) allergic reactions to anesthetic agents required in bronchoscopy; (v) patients with uncorrectable coagulation dysfunction; and (vi) patients who have already completed BT; (II) relative contraindications: (i) patients unable to discontinue anticoagulants or antiplatelet drugs due to other medical conditions; (ii) those with uncontrolled asthma resulting in severe impairment of pulmonary function; (iii) history of a near-fatal asthma attack; and (iv) other uncontrolled comorbidities (19).…”

Section: Indications and Contraindicationsmentioning

confidence: 99%

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Recent advances in bronchial thermoplasty for severe asthma: a narrative review

Wu¹,

Li²,

Zhang³

et al. 2022

Ann Transl Med

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Background and Objective: Severe asthma refers to asthma that requires step 4 or 5 therapy recommended by Global Initiative for Asthma (GINA) to prevent it from becoming uncontrolled or remaining "uncontrolled" despite this therapy. The poor treatment effect of severe asthma has been perplexing clinicians, which reduces the quality of life (QoL) of patients with asthma, and increases the mortality of such patients, so improving the therapeutic effect of severe asthma is an urgent problem to be solved in the clinic. Bronchial thermoplasty (BT) is a new non-drug therapy for severe asthma that is difficult to control with medications. It has been approved for clinical practice in China and the United States. The article aims at providing a new treatment option for patients with severe asthma that is poorly controlled by medications, thus improving the QoL in these patients.Methods: An extensive literature search was performed in the PubMed database, with "bronchial thermoplasty" as the key term. The full texts of all potentially relevant articles were obtained, and relevant information was extracted.

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Section: Operating Procedures and Its Principlesmentioning

confidence: 99%

Section: Indications and Contraindicationsmentioning

confidence: 99%

Recent advances in bronchial thermoplasty for severe asthma: a narrative review

Wu¹,

Li²,

Zhang³

et al. 2022

Ann Transl Med

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“…Induced sputum was eosinophilic (62%; normally < 3.0%) and fractional exhaled nitric oxide (FeNO) test read 58 ppb. Following the protocol for perioperative management [12], she was given 30 mg prednisone daily for 5 days. On the day of procedure, her FEV 1 had raised to 2.60 L (97.4% predicted), and FEV 1 /FVC to 80.25%.…”

Section: Case Presentationmentioning

confidence: 99%

“…The patient underwent the first session of standard BT according to the wide-accepted Chinese guidelines with 87 effective activations delivered to the right lower lobe [12]. During the procedure, the airways were noted to be clear with normal appearance on bronchoscopy.…”

Section: Case Presentationmentioning

confidence: 99%

Puzzling onsets of pneumonia sequentially after each session of bronchial thermoplasty: a case report

Nong

Lin

2020

BMC Pulm Med

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Background: Bronchial thermoplasty (BT) is a novel bronchoscopic intervention for severe persistent asthma. An increase in transient respiratory adverse events associated with BT were noted over the treatment periods, however, these events appear sporadic and should not always recur in a single individual and BT-related pneumonia has rarely been reported. Case presentation: We present a case of uncontrolled severe asthma who developed puzzling pneumonia sequentially after each session of BT procedures. After each operation of three sequential BT procedures, she developed cough and purulent expectoration when her chest radiology showed new infiltrates right in the treatment regions. After empirical use of antibacterial agents plus physiotherapy and postural sputum drainage, her symptoms vanished and chest imaging resumed normal. Conclusion: The originality of our case report is related to the recurrence of pneumonia after three sequential BT procedures. To date, similar report has not been available in the literature. We hope to prompt alerts for post-BT respiratory infections, although most of them, along with other adverse events, are mild and tractable.

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“…To ensure the BT safety and efficacy, efforts should be exerted to a number of important issues, i.e. prudent identification of surgical indications, proper selection of candidates, pre-operative assessment of pulmonary lung functions and comorbidities, rigorous adherence to procedure protocols, use of suitable anesthesia, and post-thermoplastic follow-up (152).…”

Section: Bronchial Thermoplasty (Bt)mentioning

confidence: 99%