Acute exacerbation of interstitial pneumonia following surgical lung biopsy

Kondoh, Yasuhiro; Taniguchi, Hiroyuki; Kitaichi, Masanori; Yokoi, Toyoharu; Johkoh, Takeshi; Oishi, Takashi; Kimura, Tomoki; Nishiyama, Osamu; Kato, Keisuke; Bois, Roland M. du

doi:10.1016/j.rmed.2006.02.002

Cited by 165 publications

(140 citation statements)

References 19 publications

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“…27,[37][38][39][40][41][42][43][44][45][46][47][48][49] Nine studies were retrospective, 27 39,41 one in immunocompromised subjects with pulmonary infiltrates, 38 and one including subjects from all 3 categories 46 (Table 1). The studies were generally of good quality (Table 2), with the median (interquartile range) QualSyst score being 18 (17)(18)(19). The inter-observer agreement for scoring of study quality was good (weighted Cohen's kappa ϭ 70.3%).…”

Section: Resultsmentioning

confidence: 92%

“…7 This is much lower than that for surgical lung biopsy (2-17%). [17][18][19][20][21][22][23] It is noteworthy that all of the studies considered in this review have excluded patients who had reduced lung function, evidence of pulmonary artery hypertension on echocardiography, hemodynamic instability, hypoxemia, or coagulopathy. Thus, the findings of safety of cryo-transbronchial lung biopsy in the present analysis do not apply to patients presenting with any of these features.…”

Section: Discussionmentioning

confidence: 99%

“…It may be associated with significant morbidity (2-20%), including prolonged air leak and prolonged hospital admission, and mortality (2-17%). [17][18][19][20][21][22][23] Transbronchial lung biopsy can also be performed using cryoprobes, termed cryo-transbronchial lung biopsy. 24 Cryotherapy works on the principle of the Joule-Thomson effect, wherein the adiabatic expansion of a compressed gas leads to rapid cooling.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Yield and Safety of Cryoprobe Transbronchial Lung Biopsy in Diffuse Parenchymal Lung Diseases: Systematic Review and Meta-Analysis

et al. 2016

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BACKGROUND: Transbronchial lung biopsy with flexible forceps is the most commonly used technique in diagnosis of diseases diffusely involving the lung parenchyma. Recently, transbronchial lung biopsy using the flexible cryoprobe (cryo-transbronchial lung biopsy) has also been reported. Herein, we perform a systematic review and meta-analysis describing the efficacy and safety of cryo-transbronchial lung biopsy. METHODS: The PubMed and EMBASE databases were searched for studies reporting the outcomes of cryo-transbronchial lung biopsy in subjects with diffuse parenchymal lung involvement. The quality of individual studies was assessed using the QualSyst tool. The pooled diagnostic yield of cryo-transbronchial lung biopsy was calculated using proportion meta-analysis (random effects model). Heterogeneity was evaluated using the I 2 test and Cochran Q test. Publication bias was determined using both statistical and graphical methods.

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Section: Resultsmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic Yield and Safety of Cryoprobe Transbronchial Lung Biopsy in Diffuse Parenchymal Lung Diseases: Systematic Review and Meta-Analysis

et al. 2016

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“…For example, idiopathic AE-IPF is more common in the winter months [24,30], and in patients that are immunosuppressed [9], indicating that some cases of idiopathic AE-IPF may be triggered by a preceding infection [40][41][42]. Additional potential triggers that can lead to a similar presentation in patients with IPF include aspiration [43,44], pollution [45], thoracic surgical procedures [20,25,26,37,[46][47][48][49][50], cryobiopsy [51] and, possibly, bronchoalveolar lavage [20,52]. AE-IPF has also been reported following non-pulmonary surgery [47], potentially related to mechanical trauma secondary to mechanical ventilation.…”

Section: Aetiology and Risk Factorsmentioning

confidence: 99%

Acute exacerbation of idiopathic pulmonary fibrosis: shifting the paradigm

et al. 2015

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The goal of this review is to summarise the clinical features, management, and prognosis of acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF). AE-IPF has previously been defined based on clinical and radiological features that include the subacute onset of dyspnoea, bilateral ground glass changes on chest high-resolution computed tomography, and the absence of an identifiable aetiology. The annual incidence of AE-IPF is typically reported at 5-15%, but is less common in mild disease. Features of diffuse alveolar damage are present when a biopsy is performed. Idiopathic pulmonary fibrosis (IPF) patients with acute respiratory worsening are often initially treated with high dose corticosteroids and antimicrobials; however, there are no clear data to support these therapies, and the short-term mortality of AE-IPF is ∼50%. Recent studies have shown that the features and prognosis of AE-IPF are similar to other causes of acute respiratory worsening, including infection, aspiration, air pollution and mechanical injury to the alveolar epithelium. Based on this emerging evidence, we propose a novel approach to the classification of acute respiratory worsening events in patients with IPF that focuses on clinical and radiological findings consistent with an underlying pathobiology of diffuse alveolar damage. @ERSpublications A review summarising the features, management, and prognosis of acute exacerbations of idiopathic pulmonary fibrosis

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“…The 30-day mortality after surgical lung biopsy in patients with interstitial lung disease ranges from 2.7% to 12% (56,57), and in patients with idiopathic pulmonary fibrosis, can be as high as 21.7% (58). Acute exacerbations of ILD have been described after surgical biopsies which can increase substantially its morbidity (59). Due to the high morbidity and mortality of surgical lung biopsies, there is a strong interest in the adoption of an alternative method to provide adequate tissue.…”

Section: Bronchoscopic Cryobiopsiesmentioning

confidence: 99%

Recent advances in diagnostic bronchoscopy

2016

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EBUSConvex-Probe EBUS is a technique that allows real-time sonographic visualization of peri-bronchial structures during bronchoscopy using an ultrasound transducer which is mounted at the tip of the bronchoscope (3). Its advent at the beginning of the 21st century dramatically changed Abstract: The field of diagnostic bronchoscopy has been revolutionized in the last decade primarily with the advent of endobronchial ultrasound (EBUS) but also with the addition of multiple different techniques for "guided-bronchoscopy". These advances have had a substantial impact in the management of lung cancer with bronchoscopy now providing both diagnosis and mediastinal staging in a single procedure.EBUS has, in fact, become the first choice for staging of the mediastinum over cervical mediastinoscopy (CM). Although EBUS is now a well-established technique, there are continuous efforts from the scientific community to improve its diagnostic performance, and these will be reviewed in this manuscript. The term "guided-bronchoscopy" was recently coined to describe a myriad of techniques that guide our bronchoscopes or bronchoscopic tools into the periphery of the lungs in addition to our conventional fluoroscopy.Electromagnetic and non-electromagnetic navigation, thin and ultrathin scopes, as well as radial-probe EBUS have collectively increased our yield for smaller peripheral lung lesions and continue to evolve.Despite this improved diagnostic yield, there is still ample room for improvement and newer techniques are under way. With new therapies available for patients with interstitial lung disease, achieving a specific histologic diagnosis is now of paramount importance. Given the high morbidity and mortality of surgical biopsies, bronchoscopic cryobiopsy is being rapidly adopted as a safer and effective alternative, and it is likely going to play a major role in the management of these diseases in the near future. This manuscript we will focus on recent advances in EBUS, guided-bronchoscopy, and the use of cryobiopsy.

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Acute exacerbation of interstitial pneumonia following surgical lung biopsy

Abstract: It is important to be aware of the possibility of acute exacerbation of interstitial pneumonia following SLB even after an apparently uneventful immediate postoperative course. The asymmetric image findings suggest that intraoperative respiratory management is a possible etiologic factor.

Cited by 165 publications

References 19 publications

Diagnostic Yield and Safety of Cryoprobe Transbronchial Lung Biopsy in Diffuse Parenchymal Lung Diseases: Systematic Review and Meta-Analysis

Diagnostic Yield and Safety of Cryoprobe Transbronchial Lung Biopsy in Diffuse Parenchymal Lung Diseases: Systematic Review and Meta-Analysis

Acute exacerbation of idiopathic pulmonary fibrosis: shifting the paradigm

Recent advances in diagnostic bronchoscopy

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