Endobronchial Balloon Blockers: A Retrospective Analysis of Their Implementation for Use in Transbronchial Cryobiopsy Under Conscious Sedation
- 17 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Lung
- Vol. 199 (2), 187-193
- https://doi.org/10.1007/s00408-021-00424-y
Abstract
Introduction Transbronchial lung cryobiopsy (TBLC) is a promising technique that is evolving as a standard diagnostic procedure in the diagnosis of interstitial lung disease. However, there are a variety of non-standardised techniques adopted for this procedure. We aim to describe our approach to TBLC with balloon blockade under conscious sedation (CS). Methods We performed a retrospective analysis of patients undergoing TBLC using flexible bronchoscopy under CS in our institution over the calendar years 2017–2018; before and after a transition to the use of endobronchial balloon blockers (EBB) in 2017. Results 25 patients underwent transbronchial cryobiopsy during the study period. Of these; 12 procedures used EBB. EBB subjects had significantly less moderate or severe airway bleeding (8.3% vs 38.5%) despite higher biopsy rates in the EBB group, 2.9 (2–4) vs 2.4 (1–4) in the non-EBB group. No severe airway bleeding occurred in the EBB group. A multidisciplinary meeting (MDM) confirmed diagnosis was achieved in 88% of patients. 10/12 subjects (83%) in the EBB group and 12/13 subjects (92%) in the non-EBB group (p = 0.5). Conclusion Our institution is novel in using EBB as standard during TBLC specifically under CS with flexible bronchoscopy in the bronchoscopy suite. This retrospective analysis demonstrates that EBB enhances the safety profile of performing TBLC under CS and did not appear to impact diagnostic yield or patient safety.This publication has 34 references indexed in Scilit:
- Histological diagnosis of interstitial lung diseases by cryo‐transbronchial biopsyRespirology, 2014
- Transbronchial Lung Cryobiopsy in the Diagnosis of Fibrotic Interstitial Lung DiseasesPLOS ONE, 2014
- Bronchoscopic Cryobiopsy for the Diagnosis of Diffuse Parenchymal Lung DiseasePLOS ONE, 2013
- Transbronchial Cryobiopsy in Immunocompromised Patients with Pulmonary Infiltrates: A Pilot StudyLung, 2013
- British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICEThorax, 2013
- Transbronchial cryo‐biopsy in lung transplantation patients: First reportRespirology, 2013
- Cryoprobe Transbronchial Lung Biopsy in Patients After Lung TransplantationSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2013
- Morphometrical analysis of transbronchial cryobiopsiesDiagnostic Pathology, 2011
- Transbronchial Cryobiopsy: A New Tool for Lung BiopsiesRespiration, 2009
- Controlled Sedation with Alphaxalone-AlphadoloneBMJ, 1974