Cleveland Clinic recommended priority tiers for bronchoscopy and pleural procedures
| Emergency (Proceed same day) | Critical (Proceed 1-2 days) | Urgent (Most proceed within 1-2 weeks) | Semi-urgent (Some proceed; > 2 weeks) | Nonessential (Postpone or reschedule) |
|---|---|---|---|---|
| Central airway obstruction Critical tracheal stenosis Massive hemoptysis Tracheostomy complications Foreign body aspiration Aerodigestive fistula ICU: Therapeutic aspiration of clot or mucus occlusion Chest tube for pneumothorax | Symptomatic bronchial stenosis Malignant airway obstruction Advanced lung cancer diagnosis/staging Pulmonary infiltrates in immunosuppressed patients Sub-massive hemoptysis Inpatient with undiagnosed metastatic chest cancer Stent complications Lung transplant dehiscence Thoracentesis symptomatic pleural effusion Percutaneous tracheostomy | Early stage lung cancer diagnosis/stage Routine stent change Complex tracheostomy management Lobar atelectasis (not responding to CPT) Broncholithiasis Tunneled pleural catheter (PleurX) | Lung transplant rejection follow-up BAL for unresolving infiltrate (eg, MAC) Suspect sarcoidosis/beryllium Cryobiopsy for ILD Asthma “airway” evaluation Tracheostomy tube change/revision Bronchopleural fistula assessment Thoracentesis for hepatic hydrothorax management | Lung transplant surveillance Bronchoscopic lung volume reduction Bronchial thermoplasty Retrograde airway reconstruction Excessive dynamic airway collapse evaluation Bronchogenic cyst Custom 3D printed stent Valve removal (asymptomatic after BPF or BLVR) |
BAL = bronchoalveolar lavage; BLVR = bronchoscopic lung volume reduction; BPF = bronchopleural fistula; CPT = chest physiotherapy; ICU = intensive care unit; ILD = interstitial lung disease; MAC = Mycobacterium avium complex