Transbronchial lung cryobiopsy (TBLC) is becoming more used as a way of diagnosing interstitial lung diseases (ILD). For a study, researchers sought to identify risk variables for clinically significant TBLC problems in ILD patients.
Patients with probable ILD who were sent to Kuopio or Tampere university hospitals in Finland were included in the study. The TBLC was done on 100 individuals in an outpatient environment. In general anesthesia, patients were mechanically ventilated. Fluoroscopy and a prophylactic bronchial balloon were employed for guiding. Complications including bleeding, pneumothorax, infections, and death were documented. Clinically significant consequences were classified as moderate or severe bleeding, pneumothorax, or death within 90 days or less than that. To determine clinically significant problems, a multivariable model was developed.
The severity of traction bronchiectasis (Odds ratio [OR] 1.30, CI:1.03-1.65, P=0.027) and young age (OR 7.96, CI 2.32-27.3, P=0.001) were associated with the risk of clinically significant complications, whereas the use of oral corticosteroids around or less than 30 days before the TBLC (OR 3.65, CI 0.911-14.6, P=0.068 A history of severe cough was linked to an increased risk of pneumothorax (OR 4.18, 95% CI 1.10-16.0, P=0.036). After around 90-days or less than that, the procedure-related mortality was 1%.
On HRCT, the amount of traction bronchiectasis and young age were linked with a higher risk of clinically relevant problems, although oral corticosteroid usage did not achieve statistical significance. The probability of clinically significant pneumothorax was linked to a history of severe cough.