Joseph Cooley1, Rick Balestra2, Alejandro A Aragaki-Nakahodo3, Danielle N Caudell Stamper3, Thitiwat Sriprasart4, Zulma Swank5, Robert P Baughman3, Sadia Benzaquen3. 1. Department of Internal Medicine, University of Cincinnati Medical Center, USA. Electronic address: cooleyjc@ucmail.uc.edu. 2. Providence Health & Services of Oregon and Southwest Washington, Division of Pulmonary and Critical Care Medicine, USA. 3. Division of Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati Medical Center, USA. 4. Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. 5. Department of Internal Medicine, University of Cincinnati Medical Center, USA.
Abstract
INTRODUCTION: Transbronchial lung cryobiopsy (TBLC) has become a popular option for tissue diagnosis of interstitial lung disease (ILD), however reports vary regarding the safety of this procedure. Herein, we evaluate the safety of transbronchial cryobiopsy in hospitalized patients, comparing adverse events to outpatient procedures. METHODS AND MEASUREMENTS: This is a single center, retrospective chart review of all TBLC performed for suspected ILD between November 2013 and March 2017. Biopsies were performed by a board certified interventional pulmonologist or interventional pulmonology fellow using a two-scope technique. RESULTS: One hundred fifty-nine cryobiopsies were performed for the diagnosis of ILD. Rates of adverse events are as follows: pneumothorax 11%, persistent air leak 1.3%, moderate-severe bleeding 3.8%, ICU transfer within 48 h 3.1%, and all cause 30-day mortality 1.9%. No deaths were attributed to the procedure. Comparing adverse events between hospitalized patients and outpatients, rates of pneumothorax were 24% vs 9.9%, persistent air leak 5.9% vs 0.7%, ICU transfer 12% vs 2.1%, and 30-day mortality 5.9% vs 1.4%. However, no differences were statistically significant. CONCLUSION: Practitioners should recognize that while cryobiopsies are a high-yield, safe, and cost-effective alternative to surgical lung biopsy, not all procedures carry the same risk profiles. Hospitalized patients may have a greater propensity for pneumothorax, persistent air leak, transfer to the ICU, and 30-day mortality. Published by Elsevier Ltd.
INTRODUCTION: Transbronchial lung cryobiopsy (TBLC) has become a popular option for tissue diagnosis of interstitial lung disease (ILD), however reports vary regarding the safety of this procedure. Herein, we evaluate the safety of transbronchial cryobiopsy in hospitalized patients, comparing adverse events to outpatient procedures. METHODS AND MEASUREMENTS: This is a single center, retrospective chart review of all TBLC performed for suspected ILD between November 2013 and March 2017. Biopsies were performed by a board certified interventional pulmonologist or interventional pulmonology fellow using a two-scope technique. RESULTS: One hundred fifty-nine cryobiopsies were performed for the diagnosis of ILD. Rates of adverse events are as follows: pneumothorax 11%, persistent air leak 1.3%, moderate-severe bleeding 3.8%, ICU transfer within 48 h 3.1%, and all cause 30-day mortality 1.9%. No deaths were attributed to the procedure. Comparing adverse events between hospitalized patients and outpatients, rates of pneumothorax were 24% vs 9.9%, persistent air leak 5.9% vs 0.7%, ICU transfer 12% vs 2.1%, and 30-day mortality 5.9% vs 1.4%. However, no differences were statistically significant. CONCLUSION: Practitioners should recognize that while cryobiopsies are a high-yield, safe, and cost-effective alternative to surgical lung biopsy, not all procedures carry the same risk profiles. Hospitalized patients may have a greater propensity for pneumothorax, persistent air leak, transfer to the ICU, and 30-day mortality. Published by Elsevier Ltd.
Authors: Jin Han Park; Ji Hoon Jang; Hyun Kuk Kim; Hang-Jea Jang; Sunggun Lee; Seong-Ho Kim; Ji Yeon Kim; Hee Eun Choi; Ji-Yeon Han; Da Som Kim; Min Kyun Kang; Eunsu Kang; Il Hwan Kim; Jae Ha Lee Journal: Tuberc Respir Dis (Seoul) Date: 2022-08-02
Authors: Matthew Koslow; Eric S Edell; David E Midthun; John J Mullon; Ryan M Kern; Darlene R Nelson; Kenneth K Sakata; Teng Moua; Anja C Roden; Eunhee S Yi; Janani S Reisenauer; Paul A Decker; Jay H Ryu Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2020-10-06