Endobronchial Balloon Blockers: A Retrospective Analysis of Their Implementation for Use in Transbronchial Cryobiopsy Under Conscious Sedation

Abstract

Introduction

Transbronchial lung cryobiopsy (TBLC) is a promising technique that is evolving as a standard diagnostic procedure in the diagnosis of interstitial lung disease. However, there are a variety of non-standardised techniques adopted for this procedure. We aim to describe our approach to TBLC with balloon blockade under conscious sedation (CS).

Methods

We performed a retrospective analysis of patients undergoing TBLC using flexible bronchoscopy under CS in our institution over the calendar years 2017–2018; before and after a transition to the use of endobronchial balloon blockers (EBB) in 2017.

Results

25 patients underwent transbronchial cryobiopsy during the study period. Of these; 12 procedures used EBB. EBB subjects had significantly less moderate or severe airway bleeding (8.3% vs 38.5%) despite higher biopsy rates in the EBB group, 2.9 (2–4) vs 2.4 (1–4) in the non-EBB group. No severe airway bleeding occurred in the EBB group. A multidisciplinary meeting (MDM) confirmed diagnosis was achieved in 88% of patients. 10/12 subjects (83%) in the EBB group and 12/13 subjects (92%) in the non-EBB group (p = 0.5).

Conclusion

Our institution is novel in using EBB as standard during TBLC specifically under CS with flexible bronchoscopy in the bronchoscopy suite. This retrospective analysis demonstrates that EBB enhances the safety profile of performing TBLC under CS and did not appear to impact diagnostic yield or patient safety.

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Data Availability

Date is available from the corresponding author on reasonable request.

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Funding

No funding was received for this study.

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Authors

Contributions

Conceptualization: MTH, MPK. Data curation: LJW, KFD. Formal analysis: MTH, KFD. Investigation: MTH, MPK. Methodology: MTH, MPK, LJW, KFD. Project administration: MTH, LJW, KFD. Writing—original draft: KFD, LJW. Writing—review and editing: MTH, MPK.

Corresponding author

Correspondence to Michael T. Henry.

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The authors declare that they have no conflicts of interest, financial or otherwise, related to this study. They are prepared to sign conflicts of interest forms to this effect.

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This study protocol was approved by the regional Clinical Research Ethics Committee of Cork University Hospital.

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Deasy, K.F., Walsh, L.J., Kennedy, M.P. et al. Endobronchial Balloon Blockers: A Retrospective Analysis of Their Implementation for Use in Transbronchial Cryobiopsy Under Conscious Sedation. Lung (2021). https://doi.org/10.1007/s00408-021-00424-y

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Keywords

  • Cryobiopsy
  • Balloon blockers
  • Conscious sedation