Interstitial lung diseases (ILD) are a diverse set of conditions known as diffuse parenchymal lung diseases. They are classified based on clinical, physiologic, radiological, and pathologic characteristics, with varying results and substantial overlap, which can provide a diagnostic challenge with prognostic and therapeutic consequences. Idiopathic pulmonary fibrosis (IPF) is the most frequent kind of ILD. However, progressive fibrotic lung disease occurs in 13-40% of non-IPF fibrotic ILD. Transbronchial lung cryobiopsy (TBLC) has emerged as a viable alternative to surgical lung biopsy for the detection of interstitial lung illness. However, due to a lack of procedural standardization, especially the size of the cryoprobe used, there is still doubt about its overall difficulties.

A prospective cohort study of a protocolized transbronchial cryobiopsy program using a 2.4 mm cryoprobe was conducted. A single academic center had 201 subjects enrolled in a row.

The average size of a biopsy was 106.2 ± 39.3 mm2. Complications included a 4.9% overall pneumothorax rate, with 3.5% requiring chest tube installation. The Nashville Working Group characterized severe bleeding as occurring in 0.5% of cases. At the 30-day mark, there had been no deaths.

A protocolized transbronchial cryobiopsy program with a 2.4 mm cryoprobe in place can produce a high diagnostic yield while maintaining a good safety profile.

Reference: resmedjournal.com/article/S0954-6111(22)00178-0/fulltext

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