Ambu® aScope™ 4 Broncho

Product/Technology Description

The Ambu® aScope™ 4 Broncho is designed for and used in treatments in intensive care units, theatres and emergency departments, including airway inspection, management of retained secretion, bronchoscopic sampling, and percutaneous dilatational tracheostomy, in addition to its widely accepted role in the management of unexpected difficult airways. The Ambu® aScope™ 4 Broncho Sampler Set is designed for collecting bronchial alveolar lavage (BAL) and bronchial wash (BW) samples.

Additional links:

Pulmonology website
 

IPS Opinion:

The company presented a portfolio of evidence published in the scientific literature alongside the completed IPS Industry Insights Product Review proforma. The Panel considered the infection control aspects of the products  

The infection control benefits of these two combined products which are presented sterile (and as a closed system for specimen taking) have the ability to:

  • Negate the infection risks associated with patients being exposed to contaminated scopes. 
  • Negate outbreaks associated with scopes. (Scope decontamination failure is recognised as a risk).  
  • Reduce specific infection risks during aerosol generating procedures – specifically to HCWs associated, e.g. Mycobacterium tuberculosis and SARS-CoV-2. 
  • Reduce environmental contamination – as specimen taking is presented with a closed system. 
  • Reduce the need for antibiotics as infection and outbreak risks are reduced. This should also reduce the need for antibiotics and thus the pressure on antibiotic resistant organisms in care environments. 
  • Reduce the risk of cross-contamination during re-processing (patients, healthcare workers, equipment and other scopes). 

The Panel is unsure that outbreak costs were considered in the evaluation of costs but as many infection and non-infection outbreaks happen (and are not published), significant costs in tracing events would also be negated.

References

Ambu have asked that the below references are added to this page by way of information. They have not been part of the IPS Review.

  1. Markedahl, A., Lindvig, A., Pagh, A., & Russel, R. Cost-Utility Analysis of the Ambu aScope™ 4 Broncho Single-use Flexible Video Bronchoscope Compared to Reusable Flexible Video Bronchoscopes. 2020;1–6
     
  2. Mouritsen, JM., Ehlers, LH., Kovaleva, J., Ahmad, I., El-Boghdadly, K., & El-Boghdadly, K. A systematic review and cost effectiveness analysis of reusable vs. single-use flexible bronchoscopes. Anaesthesia, 2019; 75(4), anae.14891. https://doi.org/10.1111/anae.14891
     
  3. Ahmad I, Wade S, Langdon A, Chamarette H, Walsh M, Surda P. Awake tracheal intubation in a suspected COVID-19 patient with critical airway obstruction. Anesthesia Reports, 2020;8(1):28-31, https://doi.org/10.1002/anr3.12041
     
  4. Gavaldà, L., Olmo, AR., Hernández, R., Domínguez, MA., Salamonsen, MR., Ayats, J., et al. Microbiological monitoring of flexible bronchoscopes after high-level disinfection and flushing channels with alcohol: Results and costs. Respiratory Medicine, 2015; 109(8), 1079–1085. https://doi.org/10.1016/j.rmed.2015.04.015
  5. Flandes, J., Giraldo-Cadavid, LF., Alfayate, J., Fernandez-Navamuel, I., Agusti, C., Lucena, CM., et al. Bronchoscopist’s perception of the quality of the single-use bronchoscope (Ambu aScopeTM 4) in selected bronchoscopies: a multicenter study in 21 Spanish pulmonology services. Respiratory Research, 2020; 21(1), 320. https://doi.org/10.1186/s12931-020-01576-w
     
  6. Kriege, M., Dalberg, J., McGrath, BA., Shimabukuro-Vornhagen, A., Billgren, B., Lund, TK., et al. Evaluation of intubation and intensive care use of the new Ambu® aScopeTM 4 broncho and Ambu® aViewTM compared to a customary flexible endoscope a multicentre prospective, non-interventional study. Trends in Anaesthesia and Critical Care, 2020;31, 35–41. https://doi.org/10.1016/j.tacc.2020.02.001
     
  7. Singh S, Shah PL. Safe and Efficient Practice of Bronchoscopic Sampling from Mechanically Ventilated Patients: A Structured Evaluation of the Ambu Bronchosampler-aScope 4 Integrated System. Respiration. 2021;100(1):27-33. https://doiorg/10.1159/000511982
     
  8. Taton O, Papleux E, Bondue B, Knoop C, Van Laethem S, Bauler A, et al. Role of the Bronchoalveolar Lavage in Noncritically Ill Patients during the SARS-CoV-2 Epidemic. Pulm Med. 2020;2020:9012187. doi: 10.1155/2020/9012187.
     
  9. Zaidi, SR., Collins, AM., Mitsi, E., Reine, J., Davies, K., Wright, AD., et al. Single use and conventional bronchoscopes for bronchoalveolar lavage (BAL) in research: A comparative study (NCT 02515591). BMC Pulmonary Medicine, 2017; 17(1). https://doi.org/10.1186/s12890-017-0421-7
     
  10. Chateauvieux, C., Farah, L., Guerot, E., Wermert, D., Pineau, J., Prognon, P., et al. Single-use flexible bronchoscopes compared
    with reusable bronchoscopes: Positive organizational impact but a costly solution. Journal of Evaluation in Clinical Practice, 2018; 24(3), 528–535. https://doi.org/10.1111/jep.12904
     
  11. Sørensen BL and Grüttner H. Comparative Study on Environmental Impacts of Reusable and Single-Use Bronchoscopes, Am. J.Environ. Prot., 2018; vol. 7, no. 4, p. 8, doi: 10.11648/j.ajep.20180704.11.