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Cryoprobe Transbronchial Lung Biopsy in Lung Transplant Patients: A Safety Pilot.
MedLine Citation:
PMID:  23328889     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ABSTRACT BACKGROUND: Transbronchial biopsies using standard forceps (FTBBx) are often limited by crush artifact and their small size. To date, there have been no studies aimed at assessing the safety and efficacy of cryoprobe biopsies (CPBx) in the lung transplant population. We present the safety profile and biopsy results from the first 21 procedures in a pilot study comparing CPBx to FTBBx in patients after lung transplantation. METHODS: Lung transplant patients scheduled for bronchoscopy were sequentially enrolled between November 2011 and September 2012. Inclusion criteria included age > 18 years and bilateral orthotopic lung transplantation. Exclusion criteria were coagulopathy, FEV1 < 0.8L, diffuse bullous disease, hemodynamic instability and severe hypoxemia (PaO2 < 55mmHg or SpO2 < 92% on room air). Twenty-one procedures were performed: ten using rigid bronchoscopy followed by eleven via flexible bronchoscopy. Patients were monitored for complications including pneumothorax, hemodynamic instability and/or respiratory distress. Bleeding was categorized on an adapted grading system. RESULTS: Twenty-one procedures in seventeen patients, (52 years, 12 males) were performed. Specimen area and percent open alveoli were significantly greater using CPBx compared to FTBBx (p<0.05). No clinically significant procedural complications occurred and all patients were discharged the day of the procedure. CONCLUSION: The use of the cryoprobe is a safe alternative technique to transbronchial forceps biopsy during post-lung transplant bronchoscopy. Further studies are needed to determine if larger samples obtained with CPBx translate to an increased diagnostic yield.
Authors:
Lonny Yarmus; Jason Akulian; Christopher Gilbert; Peter Illei; Pali Shah; Christian Merlo; Jon Orens; David Feller-Kopman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-17
Journal Detail:
Title:  Chest     Volume:  -     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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