Application and prospect of lung biopsy in acute respiratory distress syndrome_West China Medical Journal

Authors：

HE Qian ^1,2 ,  WANG Ye ¹

1. Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Geriatrics, Chengdu Dekang Hospital, Chengdu, Sichuan 610091, P. R. China;

Corresponding author：

WANG Ye, Email: doctordream0630@163.com

Keywords：

Acute respiratory distress syndrome; surgical lung biopsy; transbronchial lung cryobiopsy; transbronchial lung biopsy; percutaneous lung biopsy

DOI：

10.7507/1002-0179.202212082

Video：

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Acute respiratory distress syndrome is a clinical syndrome caused by many reasons, which is characterized by intractable hypoxemia. Its etiology is complex and its mortality is high. Lung biopsy techniques can give accurate histopathological diagnosis to such patients to guide treatment and improve prognosis. At present, lung biopsy techniques include surgical lung biopsy, transbronchial lung cryobiopsy, transbronchial lung biopsy and percutaneous lung biopsy. The diagnostic rate of surgical lung biopsy is high, but it is traumatic and difficult to implement. The diagnostic rate of transbronchial cryobiopsy is relatively high, and the complications are acceptable. Transbronchial lung biopsy is minimally invasive but the diagnostic rate is low. The diagnostic rate of percutaneous lung biopsy is relatively high, and the complications are relatively few. For patients with acute respiratory distress syndrome who need lung biopsy, it is very important to choose different surgical procedures according to their effectiveness, safety and applicability.

Citation： HE Qian, WANG Ye. Application and prospect of lung biopsy in acute respiratory distress syndrome. West China Medical Journal, 2023, 38(1): 12-17. doi: 10.7507/1002-0179.202212082 Copy

1.	Ashbaugh DG, Bigelow DB, Petty TL, et al. Acute respiratory distress in adults. Lancet, 1967, 2(7511): 319-323.
2.	Bernard GR, Artigas A, Brigham KL, et al. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med, 1994, 149(3 Pt 1): 818-824.
3.	ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA, 2012, 307(23): 2526-2533.
4.	Aublanc M, Perinel S, Guérin C. Acute respiratory distress syndrome mimics: the role of lung biopsy. Curr Opin Crit Care, 2017, 23(1): 24-29.
5.	中国医师协会呼吸医师分会呼吸危重症专委会, 中国医师协会呼吸医师分会介入呼吸病学工作委员会. 呼吸危重症患者行肺组织活检操作的专家意见. 中华医学杂志, 2022, 102(22): 1641-1647.
6.	Zhou G, Feng Y, Wang S, et al. Transbronchial lung cryobiopsy may be of value for nonresolving acute respiratory distress syndrome: case series and systematic literature review. BMC Pulm Med, 2020, 20(1): 183.
7.	Ghiani A, Neurohr C. Diagnostic yield, safety, and impact of transbronchial lung biopsy in mechanically ventilated, critically ill patients: a retrospective study. BMC Pulm Med, 2021, 21(1): 15.
8.	Libby LJ, Gelbman BD, Altorki NK, et al. Surgical lung biopsy in adult respiratory distress syndrome: a meta-analysis. Ann Thorac Surg, 2014, 98(4): 1254-1260.
9.	Thompson BT, Chambers RC, Liu KD. Acute respiratory distress syndrome. N Engl J Med, 2017, 377(6): 562-572.
10.	Reynolds HN, McCunn M, Borg U, et al. Acute respiratory distress syndrome: estimated incidence and mortality rate in a 5 million-person population base. Crit Care, 1998, 2(1): 29-34.
11.	Papazian L, Doddoli C, Chetaille B, et al. A contributive result of open-lung biopsy improves survival in acute respiratory distress syndrome patients. Crit Care Med, 2007, 35(3): 755-762.
12.	Baumann HJ, Kluge S, Balke L, et al. Yield and safety of bedside open lung biopsy in mechanically ventilated patients with acute lung injury or acute respiratory distress syndrome. Surgery, 2008, 143(3): 426-433.
13.	Ferson PF, Landreneau RJ, Dowling RD, et al. Comparison of open versus thoracoscopic lung biopsy for diffuse infiltrative pulmonary disease. J Thorac Cardiovasc Surg, 1993, 106(2): 194-199.
14.	Kao KC, Tsai YH, Wu YK, et al. Open lung biopsy in early-stage acute respiratory distress syndrome. Crit Care, 2006, 10(4): R106.
15.	Arab WA, Sirois M, Sirois C. Open lung biopsy in patients with respiratory failure. Clin Surg Res Commun, 2020, 4(1): 1-9.
16.	Arrieta E, Sangiovanni S, Garcia-Robledo JE, et al. Video-assisted thoracoscopic lung biopsy in critically ill patients with hematologic malignancy and acute respiratory distress syndrome: a case series report. J Investig Med High Impact Case Rep, 2020, 8: 2324709620912101.
17.	Kramer MR, Berkman N, Mintz B, et al. The role of open lung biopsy in the management and outcome of patients with diffuse lung disease. Ann Thorac Surg, 1998, 65(1): 198-202.
18.	Papazian L, Thomas P, Bregeon F, et al. Open-lung biopsy in patients with acute respiratory distress syndrome. Anesthesiology, 1998, 88(4): 935-944.
19.	Cheson BD, Samlowski WE, Tang TT, et al. Value of open-lung biopsy in 87 immunocompromised patients with pulmonary infiltrates. Cancer, 1985, 55(2): 453-459.
20.	Patel SR, Karmpaliotis D, Ayas NT, et al. The role of open-lung biopsy in ARDS. Chest, 2004, 125(1): 197-202.
21.	Chuang ML, Lin IF, Tsai YH, et al. The utility of open lung biopsy in patients with diffuse pulmonary infiltrates as related to respiratory distress, its impact on decision making by urgent intervention, and the diagnostic accuracy based on the biopsy location. J Intensive Care Med, 2003, 18(1): 21-28.
22.	Cho MH, Malhotra A, Donahue DM, et al. Mechanical ventilation and air leaks after lung biopsy for acute respiratory distress syndrome. Ann Thorac Surg, 2006, 82(1): 261-266.
23.	Lim SY, Suh GY, Choi JC, et al. Usefulness of open lung biopsy in mechanically ventilated patients with undiagnosed diffuse pulmonary infiltrates: influence of comorbidities and organ dysfunction. Crit Care, 2007, 11(4): R93.
24.	Charbonney E, Robert J, Pache JC, et al. Impact of bedside open lung biopsies on the management of mechanically ventilated immunocompromised patients with acute respiratory distress syndrome of unknown etiology. J Crit Care, 2009, 24(1): 122-128.
25.	Melo N, Figueiredo S, Morais A, et al. Open lung biopsy in patients on mechanical ventilation with suspected diffuse lung disease. Rev Port Pneumol, 2009, 15(6): 1211-1218.
26.	Wong AK, Walkey AJ. Open lung biopsy among critically ill, mechanically ventilated patients. a metaanalysis. Ann Am Thorac Soc, 2015, 12(8): 1226-1230.
27.	Warner DO, Warner MA, Divertie MB. Open lung biopsy in patients with diffuse pulmonary infiltrates and acute respiratory failure. Am Rev Respir Dis, 1988, 137(1): 90-94.
28.	Wagner JD, Stahler C, Knox S, et al. Clinical utility of open lung biopsy for undiagnosed pulmonary infiltrates. Am J Surg, 1992, 164(2): 104-107.
29.	Ferguson ND, Fan E, Camporota L, et al. The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material. Intensive Care Med, 2012, 38(10): 1573-1582.
30.	Ravaglia C, Wells AU, Tomassetti S, et al. Diagnostic yield and risk/benefit analysis of trans-bronchial lung cryobiopsy in diffuse parenchymal lung diseases: a large cohort of 699 patients. BMC Pulm Med, 2019, 19(1): 16.
31.	Babiak A, Hetzel J, Krishna G, et al. Transbronchial cryobiopsy: a new tool for lung biopsies. Respiration, 2009, 78(2): 203-208.
32.	Griff S, Ammenwerth W, Schönfeld N, et al. Morphometrical analysis of transbronchial cryobiopsies. Diagn Pathol, 2011, 6: 53.
33.	Casoni GL, Tomassetti S, Cavazza A, et al. Transbronchial lung cryobiopsy in the diagnosis of fibrotic interstitial lung diseases. PLoS One, 2014, 9(2): e86716.
34.	Griff S, Schönfeld N, Ammenwerth W, et al. Diagnostic yield of transbronchial cryobiopsy in non-neoplastic lung disease: a retrospective case series. BMC Pulm Med, 2014, 14: 171.
35.	Fruchter O, Fridel L, Rosengarten D, et al. Transbronchial cryo-biopsy in lung transplantation patients: first report. Respirology, 2013, 18(4): 669-673.
36.	Pajares V, Puzo C, Castillo D, et al. Diagnostic yield of transbronchial cryobiopsy in interstitial lung disease: a randomized trial. Respirology, 2014, 19(6): 900-906.
37.	Kropski JA, Pritchett JM, Mason WR, et al. Bronchoscopic cryobiopsy for the diagnosis of diffuse parenchymal lung disease. PLoS One, 2013, 8(11): e78674.
38.	Bango-Álvarez A, Ariza-Prota M, Torres-Rivas H, et al. Transbronchial cryobiopsy in interstitial lung disease: experience in 106 cases - how to do it. ERJ Open Res, 2017, 3(1): 00148-2016.
39.	Fruchter O, Fridel L, El Raouf BA, et al. Histological diagnosis of interstitial lung diseases by cryo-transbronchial biopsy. Respirology, 2014, 19(5): 683-688.
40.	Rodrigues I, Estêvão Gomes R, Coutinho LM, et al. Diagnostic yield and safety of transbronchial lung cryobiopsy and surgical lung biopsy in interstitial lung diseases: a systematic review and meta-analysis. Eur Respir Rev, 2022, 31(166): 210280.
41.	Troy LK, Grainge C, Corte TJ, et al. Diagnostic accuracy of transbronchial lung cryobiopsy for interstitial lung disease diagnosis (COLDICE): a prospective, comparative study. Lancet Respir Med, 2020, 8(2): 171-181.
42.	Ravaglia C, Bonifazi M, Wells AU, et al. Safety and diagnostic yield of transbronchial lung cryobiopsy in diffuse parenchymal lung diseases: a comparative study versus video-assisted thoracoscopic lung biopsy and a systematic review of the literature. Respiration, 2016, 91(3): 215-227.
43.	Cavazza A, Colby TV, Dubini A, et al. Transbronchial cryobiopsy in the diagnosis of diffuse lung disease. Surg Pathol Clin, 2020, 13(1): 197-208.
44.	Zhou G, Ren Y, Li J, et al. Safety and diagnostic efficacy of cone beam computed tomography-guided transbronchial cryobiopsy for interstitial lung disease: a cohort study. Eur Respir J, 2020, 56(2): 2000724.
45.	Cooley J, Swank ZG, Nakahodo AA, et al. Safety and utility of transbronchial lung cryobiopsy in mechanically ventilated patients with ARDS. Am J Respir Crit Care Med, 2019, 199: A1401.
46.	Sethi J, Ali MS, Mohananey D, et al. Are transbronchial cryobiopsies ready for prime time? A systematic review and meta-analysis. J Bronchology Interv Pulmonol, 2019, 26(1): 22-32.
47.	Hetzel J, Eberhardt R, Petermann C, et al. Bleeding risk of transbronchial cryobiopsy compared to transbronchial forceps biopsy in interstitial lung disease - a prospective, randomized, multicentre cross-over trial. Respir Res, 2019, 20(1): 140.
48.	Pincus PS, Kallenbach JM, Hurwitz MD, et al. Transbronchial biopsy during mechanical ventilation. Crit Care Med, 1987, 15(12): 1136-1139.
49.	Turner JS, Willcox PA, Hayhurst MD, et al. Fiberoptic bronchoscopy in the intensive care unit-a prospective study of 147 procedures in 107 patients. Crit Care Med, 1994, 22(2): 259-264.
50.	Papin TA, Grum CM, Weg JG. Transbronchial biopsy during mechanical ventilation. Chest, 1986, 89(2): 168-170.
51.	Martin C, Papazian L, Payan MJ, et al. Pulmonary fibrosis correlates with outcome in adult respiratory distress syndrome. A study in mechanically ventilated patients. Chest, 1995, 107(1): 196-200.
52.	Hennessy BJ, Dowd N, Crotty GM, et al. Respiratory failure and intensive care support following bone marrow transplantation. Hematology, 1998, 3(4): 315-319.
53.	Festic E, Gajic O, Limper AH, et al. Acute respiratory failure due to pneumocystis pneumonia in patients without human immunodeficiency virus infection: outcome and associated features. Chest, 2005, 128(2): 573-579.
54.	Burns KE, Johnson BA, Iacono AT. Diagnostic properties of transbronchial biopsy in lung transplant recipients who require mechanical ventilation. J Heart Lung Transplant, 2003, 22(3): 267-275.
55.	Bulpa PA, Dive AM, Mertens L, et al. Combined bronchoalveolar lavage and transbronchial lung biopsy: safety and yield in ventilated patients. Eur Respir J, 2003, 21(3): 489-494.
56.	Xu C, Wang Y, Wang W, et al. Improved diagnostic yield of transbronchial lung biopsy in peripheral pulmonary lesions using a combination of endobronchial ultrasound and rapid on-site evaluation. J Int Med Res, 2021, 49(3): 300060521999535.
57.	Herf SM, Suratt PM, Arora NS. Deaths and complications associated with transbronchial lung biopsy. Am Rev Respir Dis, 1977, 115(4): 708-711.
58.	吴小静, 易丽, 田野, 等. 重症监护室患者行经皮肺穿刺活检术 10 例报告. 中国实用内科杂志, 2018, 38(5): 470-472.
59.	Li QK, Ding YK, Liu Y, et al. Diagnostic yield of computed tomography-guided percutaneous lung biopsy in patients with prior nondiagnostic transbronchial biopsy. J Comput Assist Tomogr, 2020, 44(2): 305-309.
60.	Lee JH, Yoon SH, Hong H, et al. Incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy: a systematic review and pooled analysis. Eur Radiol, 2021, 31(4): 2022-2033.
61.	Manhire A, Charig M, Clelland C, et al. Guidelines for radiologically guided lung biopsy. Thorax, 2003, 58(11): 920-936.
62.	Jang H, Rho JY, Suh YJ, et al. Asymptomatic systemic air embolism after CT-guided percutaneous transthoracic needle biopsy. Clin Imaging, 2019, 53: 49-57.
63.	Zhao Y, Jiang F, Yu H, et al. Bronchus-blocked ultrasound-guided percutaneous transthoracic needle biopsy (BUS-PTNB) for intubated patients with severe lung diseases. Crit Care, 2021, 25(1): 359.
64.	Hernández-González F, Lucena CM, Ramírez J, et al. Cryobiopsy in the diagnosis of diffuse interstitial lung disease: yield and cost-effectiveness analysis. Arch Bronconeumol, 2015, 51(6): 261-267.

1. Ashbaugh DG, Bigelow DB, Petty TL, et al. Acute respiratory distress in adults. Lancet, 1967, 2(7511): 319-323.
2. Bernard GR, Artigas A, Brigham KL, et al. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med, 1994, 149(3 Pt 1): 818-824.
3. ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA, 2012, 307(23): 2526-2533.
4. Aublanc M, Perinel S, Guérin C. Acute respiratory distress syndrome mimics: the role of lung biopsy. Curr Opin Crit Care, 2017, 23(1): 24-29.
5. 中国医师协会呼吸医师分会呼吸危重症专委会, 中国医师协会呼吸医师分会介入呼吸病学工作委员会. 呼吸危重症患者行肺组织活检操作的专家意见. 中华医学杂志, 2022, 102(22): 1641-1647.
6. Zhou G, Feng Y, Wang S, et al. Transbronchial lung cryobiopsy may be of value for nonresolving acute respiratory distress syndrome: case series and systematic literature review. BMC Pulm Med, 2020, 20(1): 183.
7. Ghiani A, Neurohr C. Diagnostic yield, safety, and impact of transbronchial lung biopsy in mechanically ventilated, critically ill patients: a retrospective study. BMC Pulm Med, 2021, 21(1): 15.
8. Libby LJ, Gelbman BD, Altorki NK, et al. Surgical lung biopsy in adult respiratory distress syndrome: a meta-analysis. Ann Thorac Surg, 2014, 98(4): 1254-1260.
9. Thompson BT, Chambers RC, Liu KD. Acute respiratory distress syndrome. N Engl J Med, 2017, 377(6): 562-572.
10. Reynolds HN, McCunn M, Borg U, et al. Acute respiratory distress syndrome: estimated incidence and mortality rate in a 5 million-person population base. Crit Care, 1998, 2(1): 29-34.
11. Papazian L, Doddoli C, Chetaille B, et al. A contributive result of open-lung biopsy improves survival in acute respiratory distress syndrome patients. Crit Care Med, 2007, 35(3): 755-762.
12. Baumann HJ, Kluge S, Balke L, et al. Yield and safety of bedside open lung biopsy in mechanically ventilated patients with acute lung injury or acute respiratory distress syndrome. Surgery, 2008, 143(3): 426-433.
13. Ferson PF, Landreneau RJ, Dowling RD, et al. Comparison of open versus thoracoscopic lung biopsy for diffuse infiltrative pulmonary disease. J Thorac Cardiovasc Surg, 1993, 106(2): 194-199.
14. Kao KC, Tsai YH, Wu YK, et al. Open lung biopsy in early-stage acute respiratory distress syndrome. Crit Care, 2006, 10(4): R106.
15. Arab WA, Sirois M, Sirois C. Open lung biopsy in patients with respiratory failure. Clin Surg Res Commun, 2020, 4(1): 1-9.
16. Arrieta E, Sangiovanni S, Garcia-Robledo JE, et al. Video-assisted thoracoscopic lung biopsy in critically ill patients with hematologic malignancy and acute respiratory distress syndrome: a case series report. J Investig Med High Impact Case Rep, 2020, 8: 2324709620912101.
17. Kramer MR, Berkman N, Mintz B, et al. The role of open lung biopsy in the management and outcome of patients with diffuse lung disease. Ann Thorac Surg, 1998, 65(1): 198-202.
18. Papazian L, Thomas P, Bregeon F, et al. Open-lung biopsy in patients with acute respiratory distress syndrome. Anesthesiology, 1998, 88(4): 935-944.
19. Cheson BD, Samlowski WE, Tang TT, et al. Value of open-lung biopsy in 87 immunocompromised patients with pulmonary infiltrates. Cancer, 1985, 55(2): 453-459.
20. Patel SR, Karmpaliotis D, Ayas NT, et al. The role of open-lung biopsy in ARDS. Chest, 2004, 125(1): 197-202.
21. Chuang ML, Lin IF, Tsai YH, et al. The utility of open lung biopsy in patients with diffuse pulmonary infiltrates as related to respiratory distress, its impact on decision making by urgent intervention, and the diagnostic accuracy based on the biopsy location. J Intensive Care Med, 2003, 18(1): 21-28.
22. Cho MH, Malhotra A, Donahue DM, et al. Mechanical ventilation and air leaks after lung biopsy for acute respiratory distress syndrome. Ann Thorac Surg, 2006, 82(1): 261-266.
23. Lim SY, Suh GY, Choi JC, et al. Usefulness of open lung biopsy in mechanically ventilated patients with undiagnosed diffuse pulmonary infiltrates: influence of comorbidities and organ dysfunction. Crit Care, 2007, 11(4): R93.
24. Charbonney E, Robert J, Pache JC, et al. Impact of bedside open lung biopsies on the management of mechanically ventilated immunocompromised patients with acute respiratory distress syndrome of unknown etiology. J Crit Care, 2009, 24(1): 122-128.
25. Melo N, Figueiredo S, Morais A, et al. Open lung biopsy in patients on mechanical ventilation with suspected diffuse lung disease. Rev Port Pneumol, 2009, 15(6): 1211-1218.
26. Wong AK, Walkey AJ. Open lung biopsy among critically ill, mechanically ventilated patients. a metaanalysis. Ann Am Thorac Soc, 2015, 12(8): 1226-1230.
27. Warner DO, Warner MA, Divertie MB. Open lung biopsy in patients with diffuse pulmonary infiltrates and acute respiratory failure. Am Rev Respir Dis, 1988, 137(1): 90-94.
28. Wagner JD, Stahler C, Knox S, et al. Clinical utility of open lung biopsy for undiagnosed pulmonary infiltrates. Am J Surg, 1992, 164(2): 104-107.
29. Ferguson ND, Fan E, Camporota L, et al. The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material. Intensive Care Med, 2012, 38(10): 1573-1582.
30. Ravaglia C, Wells AU, Tomassetti S, et al. Diagnostic yield and risk/benefit analysis of trans-bronchial lung cryobiopsy in diffuse parenchymal lung diseases: a large cohort of 699 patients. BMC Pulm Med, 2019, 19(1): 16.
31. Babiak A, Hetzel J, Krishna G, et al. Transbronchial cryobiopsy: a new tool for lung biopsies. Respiration, 2009, 78(2): 203-208.
32. Griff S, Ammenwerth W, Schönfeld N, et al. Morphometrical analysis of transbronchial cryobiopsies. Diagn Pathol, 2011, 6: 53.
33. Casoni GL, Tomassetti S, Cavazza A, et al. Transbronchial lung cryobiopsy in the diagnosis of fibrotic interstitial lung diseases. PLoS One, 2014, 9(2): e86716.
34. Griff S, Schönfeld N, Ammenwerth W, et al. Diagnostic yield of transbronchial cryobiopsy in non-neoplastic lung disease: a retrospective case series. BMC Pulm Med, 2014, 14: 171.
35. Fruchter O, Fridel L, Rosengarten D, et al. Transbronchial cryo-biopsy in lung transplantation patients: first report. Respirology, 2013, 18(4): 669-673.
36. Pajares V, Puzo C, Castillo D, et al. Diagnostic yield of transbronchial cryobiopsy in interstitial lung disease: a randomized trial. Respirology, 2014, 19(6): 900-906.
37. Kropski JA, Pritchett JM, Mason WR, et al. Bronchoscopic cryobiopsy for the diagnosis of diffuse parenchymal lung disease. PLoS One, 2013, 8(11): e78674.
38. Bango-Álvarez A, Ariza-Prota M, Torres-Rivas H, et al. Transbronchial cryobiopsy in interstitial lung disease: experience in 106 cases - how to do it. ERJ Open Res, 2017, 3(1): 00148-2016.
39. Fruchter O, Fridel L, El Raouf BA, et al. Histological diagnosis of interstitial lung diseases by cryo-transbronchial biopsy. Respirology, 2014, 19(5): 683-688.
40. Rodrigues I, Estêvão Gomes R, Coutinho LM, et al. Diagnostic yield and safety of transbronchial lung cryobiopsy and surgical lung biopsy in interstitial lung diseases: a systematic review and meta-analysis. Eur Respir Rev, 2022, 31(166): 210280.
41. Troy LK, Grainge C, Corte TJ, et al. Diagnostic accuracy of transbronchial lung cryobiopsy for interstitial lung disease diagnosis (COLDICE): a prospective, comparative study. Lancet Respir Med, 2020, 8(2): 171-181.
42. Ravaglia C, Bonifazi M, Wells AU, et al. Safety and diagnostic yield of transbronchial lung cryobiopsy in diffuse parenchymal lung diseases: a comparative study versus video-assisted thoracoscopic lung biopsy and a systematic review of the literature. Respiration, 2016, 91(3): 215-227.
43. Cavazza A, Colby TV, Dubini A, et al. Transbronchial cryobiopsy in the diagnosis of diffuse lung disease. Surg Pathol Clin, 2020, 13(1): 197-208.
44. Zhou G, Ren Y, Li J, et al. Safety and diagnostic efficacy of cone beam computed tomography-guided transbronchial cryobiopsy for interstitial lung disease: a cohort study. Eur Respir J, 2020, 56(2): 2000724.
45. Cooley J, Swank ZG, Nakahodo AA, et al. Safety and utility of transbronchial lung cryobiopsy in mechanically ventilated patients with ARDS. Am J Respir Crit Care Med, 2019, 199: A1401.
46. Sethi J, Ali MS, Mohananey D, et al. Are transbronchial cryobiopsies ready for prime time? A systematic review and meta-analysis. J Bronchology Interv Pulmonol, 2019, 26(1): 22-32.
47. Hetzel J, Eberhardt R, Petermann C, et al. Bleeding risk of transbronchial cryobiopsy compared to transbronchial forceps biopsy in interstitial lung disease - a prospective, randomized, multicentre cross-over trial. Respir Res, 2019, 20(1): 140.
48. Pincus PS, Kallenbach JM, Hurwitz MD, et al. Transbronchial biopsy during mechanical ventilation. Crit Care Med, 1987, 15(12): 1136-1139.
49. Turner JS, Willcox PA, Hayhurst MD, et al. Fiberoptic bronchoscopy in the intensive care unit-a prospective study of 147 procedures in 107 patients. Crit Care Med, 1994, 22(2): 259-264.
50. Papin TA, Grum CM, Weg JG. Transbronchial biopsy during mechanical ventilation. Chest, 1986, 89(2): 168-170.
51. Martin C, Papazian L, Payan MJ, et al. Pulmonary fibrosis correlates with outcome in adult respiratory distress syndrome. A study in mechanically ventilated patients. Chest, 1995, 107(1): 196-200.
52. Hennessy BJ, Dowd N, Crotty GM, et al. Respiratory failure and intensive care support following bone marrow transplantation. Hematology, 1998, 3(4): 315-319.
53. Festic E, Gajic O, Limper AH, et al. Acute respiratory failure due to pneumocystis pneumonia in patients without human immunodeficiency virus infection: outcome and associated features. Chest, 2005, 128(2): 573-579.
54. Burns KE, Johnson BA, Iacono AT. Diagnostic properties of transbronchial biopsy in lung transplant recipients who require mechanical ventilation. J Heart Lung Transplant, 2003, 22(3): 267-275.
55. Bulpa PA, Dive AM, Mertens L, et al. Combined bronchoalveolar lavage and transbronchial lung biopsy: safety and yield in ventilated patients. Eur Respir J, 2003, 21(3): 489-494.
56. Xu C, Wang Y, Wang W, et al. Improved diagnostic yield of transbronchial lung biopsy in peripheral pulmonary lesions using a combination of endobronchial ultrasound and rapid on-site evaluation. J Int Med Res, 2021, 49(3): 300060521999535.
57. Herf SM, Suratt PM, Arora NS. Deaths and complications associated with transbronchial lung biopsy. Am Rev Respir Dis, 1977, 115(4): 708-711.
58. 吴小静, 易丽, 田野, 等. 重症监护室患者行经皮肺穿刺活检术 10 例报告. 中国实用内科杂志, 2018, 38(5): 470-472.
59. Li QK, Ding YK, Liu Y, et al. Diagnostic yield of computed tomography-guided percutaneous lung biopsy in patients with prior nondiagnostic transbronchial biopsy. J Comput Assist Tomogr, 2020, 44(2): 305-309.
60. Lee JH, Yoon SH, Hong H, et al. Incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy: a systematic review and pooled analysis. Eur Radiol, 2021, 31(4): 2022-2033.
61. Manhire A, Charig M, Clelland C, et al. Guidelines for radiologically guided lung biopsy. Thorax, 2003, 58(11): 920-936.
62. Jang H, Rho JY, Suh YJ, et al. Asymptomatic systemic air embolism after CT-guided percutaneous transthoracic needle biopsy. Clin Imaging, 2019, 53: 49-57.
63. Zhao Y, Jiang F, Yu H, et al. Bronchus-blocked ultrasound-guided percutaneous transthoracic needle biopsy (BUS-PTNB) for intubated patients with severe lung diseases. Crit Care, 2021, 25(1): 359.
64. Hernández-González F, Lucena CM, Ramírez J, et al. Cryobiopsy in the diagnosis of diffuse interstitial lung disease: yield and cost-effectiveness analysis. Arch Bronconeumol, 2015, 51(6): 261-267.

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