Trans-bronchial lung cryobiopsy in patients at high-risk of complications.
Cryobiopsy
Diffuse parenchymal lung disease
ILD
Interstitial lung disease
Pulmonary fibrosis
SLB
Surgical lung biopsy
TBLC
Trans-bronchial lung cryobiopsy
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
26 Apr 2021
26 Apr 2021
Historique:
received:
17
10
2020
accepted:
16
04
2021
entrez:
27
4
2021
pubmed:
28
4
2021
medline:
5
11
2021
Statut:
epublish
Résumé
The surgical lung biopsy (SLB) is the recommended sampling technique when the pathological analysis of the lung is required in the work-up of an interstitial lung disease (ILD) but trans-bronchial lung cryobiopsy (TBLC) is increasingly recognized as an alternative approach. As TBLCs have lower mortality and morbidity risks than SLB, this study aimed to investigate the safety of TBLCs in patients at higher risk of complications and for whom SLB was not considered as an alternative. This prospective study was conducted in two hospitals in which TBLCs were performed in patients with body mass index (BMI) > 35, and/or older than 75 years, and/or with severely impaired lung function (FVC < 50% or DLCO < 30%), and/or systolic pulmonary artery pressure > 45 mmHg, and/or a clinically significant cardiac disease. Patients with any of these risk factors constituted the high-risk group. Clinical outcomes were compared with those obtained in patients without these risk factors (low-risk group). Ninety-six patients were included between April 2015 and April 2020, respectively 38 and 58 in the high-risk or the low-risk group. No statistically significant difference was observed between both groups in terms of severity and rate of bleeding, pneumothorax, or duration of hospital stay (p value ranging from 0.419 to 0.914). This preliminary study on a limited number of patients suggests that TBLC appears safe in those in whom lung biopsy is at high-risk of complications according to their age, BMI, lung impairment, and cardiac comorbidities.
Sections du résumé
BACKGROUND
BACKGROUND
The surgical lung biopsy (SLB) is the recommended sampling technique when the pathological analysis of the lung is required in the work-up of an interstitial lung disease (ILD) but trans-bronchial lung cryobiopsy (TBLC) is increasingly recognized as an alternative approach. As TBLCs have lower mortality and morbidity risks than SLB, this study aimed to investigate the safety of TBLCs in patients at higher risk of complications and for whom SLB was not considered as an alternative.
METHOD
METHODS
This prospective study was conducted in two hospitals in which TBLCs were performed in patients with body mass index (BMI) > 35, and/or older than 75 years, and/or with severely impaired lung function (FVC < 50% or DLCO < 30%), and/or systolic pulmonary artery pressure > 45 mmHg, and/or a clinically significant cardiac disease. Patients with any of these risk factors constituted the high-risk group. Clinical outcomes were compared with those obtained in patients without these risk factors (low-risk group).
RESULTS
RESULTS
Ninety-six patients were included between April 2015 and April 2020, respectively 38 and 58 in the high-risk or the low-risk group. No statistically significant difference was observed between both groups in terms of severity and rate of bleeding, pneumothorax, or duration of hospital stay (p value ranging from 0.419 to 0.914).
CONCLUSION
CONCLUSIONS
This preliminary study on a limited number of patients suggests that TBLC appears safe in those in whom lung biopsy is at high-risk of complications according to their age, BMI, lung impairment, and cardiac comorbidities.
Identifiants
pubmed: 33902504
doi: 10.1186/s12890-021-01503-9
pii: 10.1186/s12890-021-01503-9
pmc: PMC8074461
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
135Références
Lancet Respir Med. 2020 Feb;8(2):171-181
pubmed: 31578168
Ann Am Thorac Soc. 2017 Jul;14(7):1197-1211
pubmed: 28399377
Respiration. 2018;95(3):188-200
pubmed: 29316560
BMC Pulm Med. 2019 Jan 16;19(1):16
pubmed: 30651103
J Cardiothorac Surg. 2014 Mar 10;9:45
pubmed: 24612724
Am J Respir Crit Care Med. 2018 Sep 1;198(5):e44-e68
pubmed: 30168753
Gut. 2016 Mar;65(3):374-89
pubmed: 26873868
Am J Respir Crit Care Med. 2013 Sep 15;188(6):733-48
pubmed: 24032382
Am J Respir Crit Care Med. 2016 Apr 1;193(7):745-52
pubmed: 26562389
J Thorac Dis. 2017 Jul;9(7):2186-2203
pubmed: 28840020
J Thorac Cardiovasc Surg. 2015 May;149(5):1394-401.e1
pubmed: 25648484
Pulm Med. 2017;2017:6794343
pubmed: 28512583
Ann Thorac Surg. 2017 Aug;104(2):465-470
pubmed: 28527960
Eur Respir J. 2020 Dec 10;56(6):
pubmed: 32817003
Gen Thorac Cardiovasc Surg. 2014 Jun;62(6):376-82
pubmed: 24623116
PLoS One. 2014 Feb 28;9(2):e86716
pubmed: 24586252
Asian Cardiovasc Thorac Ann. 2008 Dec;16(6):463-7
pubmed: 18984755
Eur J Cardiothorac Surg. 2007 Jun;31(6):1115-9
pubmed: 17418586
Ann Thorac Surg. 2013 Feb;95(2):445-52
pubmed: 23245450
Chest. 2005 May;127(5):1600-5
pubmed: 15888834
QJM. 2017 Apr 1;110(4):207-214
pubmed: 27521581
Eur Respir J. 2016 Nov;48(5):1453-1461
pubmed: 27660509
Respir Med. 2020 Apr - May;165:105934
pubmed: 32308202
Respiration. 2016;91(3):215-27
pubmed: 26926876
Chest. 2020 Apr;157(4):1030-1042
pubmed: 31783014