Feasibility and Safety of Transbronchial Lung Cryobiopsy for Diagnosis of Acute Respiratory Failure with Mechanical Ventilation in Intensive Care Unit
Abstract
:1. Introduction
2. Methods
2.1. Study Population
2.2. Bronchoscopy
2.3. Statistical Analyses
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
ARDS | Acute respiratory distress syndrome |
DAD | Diffuse alveolar damage |
FiO2 | Fraction of inspired oxygen |
PaO2 | Partial pressure of oxygen |
SpO2 | Oxygen saturation |
ICU | Intensive care unit |
INR | International normalized ratio |
PEEP | Positive end-expiratory pressure |
SLB | Surgical lung biopsy |
TBLB | Transbronchial lung biopsy |
TBLC | Transbronchial lung cryobiopsy |
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Characteristics | Positive Pressure at ICU (N = 10) |
---|---|
Age, years | 58.2 ± 13.45 |
Female sex, N (%) | 5 (50%) |
Body mass index, (kg/m2) | 26.7 ± 5.28 |
Active smoker, N (%) | 2 (20%) |
COPD | 0 |
asthma | 0 |
Interstitial lung disease | 0 |
hypertension | 1 |
Diabetes | 1 |
Cancer | 2 |
FiO2 | 43.88 ± 8.94 |
PaO2 | 91.68 ± 35.73 |
PaO2/FiO2 ratio | 209.78 ± 60.77 |
PEEP | 11.33 ± 2.83 |
Tidal volume, mL | 403.22 ± 93.33 |
White blood cell count | 17844.44 ± 13861.58 |
Hemoglobin | 11.37 ± 3.11 |
Platelet count | 198.33 ± 141.81 |
INR | 1.26 ± 0.18 |
Empiric antibiotics treatment before biopsy, N (%) | 10 (100) |
Days from admission to biopsy | 7.5 ± 4.95 |
ICU length of stay, days | 19.8 ± 9.8 |
Hospital days | 32.9 ± 18.69 |
Hospital mortality, N (%) | 5 (50) |
Biopsy Size | |
---|---|
Specimen diameter, cm | 0.56 ± 0.21 |
Specimen area, cm2 | 0.17 ± 0.08 |
Biopsy locations | |
Right upper lobe | 1 |
Right lower lobe | 1 |
Left upper lobe | 1 |
Lingula | 5 |
Left lower lobe | 2 |
Pathological diagnosis | |
Diffuse alveolar damage | 4 |
Cancer | 2 |
Fibrosis | 3 |
Chronic inflammation | 1 |
Treatment alteration | |
Further anti-cancer treatment | 2 |
Adding corticosteroids | 4 |
Adding anti-fibrotic treatment | 1 |
Events within 24 h Following Bronchoscopy Procedure | Numbers (N = 10) |
---|---|
No adverse events | 7 |
Fever above 38 °C | 2 |
Significant hypoxemia (oxygen saturations < 90% on FIO2 1.0) | 1 |
Tachycardia > 150 beats/min | 0 |
Ventricular arrhythmia | 0 |
Pneumothorax | 1 |
Hemorrhage requiring blood transfusion | 0 |
Death | 0 |
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Chang, C.-H.; Ju, J.-S.; Li, S.-H.; Wang, S.-C.; Wang, C.-W.; Lee, C.-S.; Chung, F.-T.; Hu, H.-C.; Lin, S.-M.; Huang, C.-C. Feasibility and Safety of Transbronchial Lung Cryobiopsy for Diagnosis of Acute Respiratory Failure with Mechanical Ventilation in Intensive Care Unit. Diagnostics 2022, 12, 2917. https://doi.org/10.3390/diagnostics12122917
Chang C-H, Ju J-S, Li S-H, Wang S-C, Wang C-W, Lee C-S, Chung F-T, Hu H-C, Lin S-M, Huang C-C. Feasibility and Safety of Transbronchial Lung Cryobiopsy for Diagnosis of Acute Respiratory Failure with Mechanical Ventilation in Intensive Care Unit. Diagnostics. 2022; 12(12):2917. https://doi.org/10.3390/diagnostics12122917
Chicago/Turabian StyleChang, Chih-Hao, Jia-Shiuan Ju, Shih-Hong Li, Shao-Chung Wang, Chih-Wei Wang, Chung-Shu Lee, Fu-Tsai Chung, Han-Chung Hu, Shu-Min Lin, and Chung-Chi Huang. 2022. "Feasibility and Safety of Transbronchial Lung Cryobiopsy for Diagnosis of Acute Respiratory Failure with Mechanical Ventilation in Intensive Care Unit" Diagnostics 12, no. 12: 2917. https://doi.org/10.3390/diagnostics12122917