PT  - JOURNAL ARTICLE
AU  - Daniels, Johannes M.A.
AU  - Nijman, Suzan F.M.
AU  - Ruiter, Gerrina
AU  - Nossent, Esther J.
TI  - Transbronchial lung cryobiopsy in interstitial lung disease: safety & learning curve
AID  - 10.1183/13993003.congress-2020.1190
DP  - 2020 Sep 07
TA  - European Respiratory Journal
PG  - 1190
VI  - 56
IP  - suppl 64
4099  - http://erj.ersjournals.com/content/56/suppl_64/1190.short
4100  - http://erj.ersjournals.com/content/56/suppl_64/1190.full
SO  - Eur Respir J2020 Sep 07; 56
AB  - Introduction: Transbronchial lung cryobiopsy (TBCB) is a minimally invasive diagnostic procedure for patients with diffuse parenchymal lung disease. Pneumothorax occurs in approximately 19% of procedures and severe hemorrhage in <1% [1]. We aimed to assess the complication rate at our institution and its development over the last 5 years.Methods: We prospectively collected data of patients that underwent TBCB. The decision to perform TBCB was taken in the multidisciplinary ILD meeting. The procedure was performed either under general anesthesia with a rigid bronchoscope or cuffed ET tube, or under propofol sedation with a Rusch Bronchoflex tube. Arndt bronchial blockers were used to block the segmental or lobar bronchus after every biopsy in order to minimize bleeding. Patients were observed for 1 night at the clinic and before discharge a chest X-ray was performed.Results: Ninety-three patients underwent TBCB. The mean number of biopsies was 3,8 ±1,3. The overall pneumothorax rate was 15,1%. The annual rate of pneumothorax declined from 29% in 2015 to 8% in 2018 and 2019 (table 1). Bleeding was controlled in all cases with the bronchial blocker. 30-day moratilty was 1/93 (1%). View this table:Table 1 Pneumothorax rate and management in five consecutive years.Conclusions: Although TBCB is a safe procedure, there seems to be a clear learning curve with respect to the incidence of pneumothorax. Careful monitoring of complications is important to learn as a team and to minimize the morbidity.References: 1. Ravaglia C et al. BMC Pulm Med 2019;19:16.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 1190.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).