Guidelines for Minimizing Bleeding Risk During Bronchoscopic Procedures
Adam Barczyk, Anna Andrychiewicz, Małgorzata Czajkowska-Malinowska, Katarzyna Górska, Bartosz Hudzik, Piotr Korczyński, Rafał Krenke, Wojciech Naumnik, Wojciech J. Piotrowski, Cezary Piwkowski, Jerzy Soja, Artur Szlubowski, Jerzy Windyga, Joanna Zając, Filip MejzaThis article presents recommendations aimed at reducing the risk of bleeding during bronchoscopy. The document was developed by a working group convened by the Polish Respiratory Society, which included pulmonologists experienced in bronchoscopic procedures, an anesthesiologist, a thoracic surgeon, a cardiologist, a hematologist, a nurse, and methodologists. Clinical questions were formulated according to the PICO (Population, Intervention, Comparison, Outcome) framework, followed by a systematic literature search and critical appraisal of the selected studies. Based on these data, 13 recommendations/good clinical practice points were developed addressing bronchoscopy in patients with thrombocytopenia, abnormal activated partial thromboplastin time or international normalized ratio results, and in those receiving antiplatelet agents, oral anticoagulants, or low-molecular-weight heparin.