Transbronchial Lung Biopsy During Mechanical Ventilation_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 NONG Lingbo , LI Shiyue , HE Weiqun , ZENG Yunxiang , LIU Xiaoqing , LI YiMin , XIAO Zhenglun.

The First Affiliated Hospital of Guangzhou Medical College, Guangzhou Institute of Respiratory Diseases. Guangzhou, Guangdong, 510120, China;

Corresponding author：

NONG Lingbo, Email: lbnong@sohu.com

Keywords：

Mechanical ventilation; Transbronchial lung biopsy; Diagnosis

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Objective To evaluate the safety and diagnostic yield of transbronchial lung biopsy ( TBLB) performed in mechanically ventilated patients. Methods TBLB was performed in 19 mechanically ventilated patients form January 2001 to September 2007 in the ICU of Guangzhou Institute of Respiratory Diseases. The results of clinical data were retrospectively analyzed. Results A total of 19 patients were analyzed[ 9 female, 10 male, with amean age of ( 57. 94 ±15. 00) years] . Specific diagnoses were made in 9 cases ( 47. 4% ) by TBLB. The diseases included pulmonary aspergillus pneumonia in 4 cases ( 21. 0% ) ,lung cancer in 2 cases ( 10. 5% ) , radioactive pneumonia in 1 case( 5. 3% ) , Goodpasture’s syndrome in1case( 5. 3% ) , pulmonary tuberculosis in 1 case ( 5. 3% ) . Ten cases ( 52. 6% ) were not able to establish confirmed diagnoses including pulmonary interstitial fibrosis in 6 cases( 31. 6% ) and lung tissue nonspecific changes in 4 cases( 21. 0% ) . The treatment was adjusted according to the results of TBLB in 10 patients( 52. 6% ) . Complications associated with this procedure included episodes of bronchial hemorrhage of ≥30 mL in 4 cases ( 21. 0% ) , transient oxygen desaturation in 11 cases ( 57. 9% ) , hypotension in 5 cases ( 26. 3% ) , and transient tachycardia in 1 case ( 5. 3% ) without death and pneumothorax. Conclusions TBLB can be performed safely and has a diagnostic value in mechanically ventilated patients. TBLB should be considered as a diagnostic procedure before open lung biopsy.

Citation： NONG Lingbo,LI Shiyue,HE Weiqun,ZENG Yunxiang,LIU Xiaoqing,LI YiMin,XIAO Zhenglun.. Transbronchial Lung Biopsy During Mechanical Ventilation. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(3): 275-278. doi: Copy

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1. 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: 90-94.
2. Flabouris A, Myburgh J. The utility of open lung biopsy in patients requiring mechanical ventilation. Chest.
3. Papin TA, Grum CM, Weg JG. Transbronchial biopsy during mechanical ventilation. Chest, 1986, 89: 168-170.
4. O′Brien JD, Ettinger NA, Shevlin D, et al. Safety and yield of transbronchial biopsy in mechanically ventilated patients. Crit Care Med, 1997, 25: 440-446.
5. American Thoracic Society, European Respiratory Society. American Thoracic Society/ European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. Am J Respir Crit Care Med, 2002, 165: 277-304.
6. Bjoraker JA, Ryu JH, Edwin MK, et al. Prognostic significance of histopathologic subsets in idiopathic pulmonary fibrosis. Am J RespirCrit Care Med, 1998, 157: 199-203.
7. Parambil JG, Myers JL, Ryu JH. Histopathologic features and outcome of patients with acute exacerbation of idiopathic pulmonary fibrosis undergoing surgical lung biopsy. Chest, 2005, 128 : 3310 -3315 .
8. 孙永昌, 陈亚红, 姚婉贞, 等. 不同肺活检方法对弥漫性肺间质性疾病的诊断价值. 中国呼吸与危重监护杂志, 2004, 4: 210-212.
9. 施举红, 许文兵, 刘鸿瑞, 等. 经支气管镜肺活检对弥漫性肺实质疾病的诊断价值. 中华结核和呼吸杂志, 2008, 31: 22-25.
10. , 115: 811-817.

Chinese Journal of Respiratory and Critical Care Medicine

Transbronchial Lung Biopsy During Mechanical Ventilation

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