Abstract
Background: TCB is an endoscopic tissue sampling technique gaining importance in diagnosis of interstitial lung diseases (ILD). It remains unclear whether this method is sufficiently safe in clinical routine.
Methods: We present preliminary data from a prospective, observational study, examining patients with idiopathic interstitial pneumonia (IIP). Patients with differential diagnosis of NSIP/IPF or unclassifiable ILD according to HRCT underwent TCB. Lung function, histological results and peri-interventional complications were documented.
Results: Until now, data from 19 ILD patients were evaluated (7 f, 66±11 y, BMI 27.7±3.2 kg/m²). Mean values showed slightly restricted ventilation and impaired gas exchange (TLC 73±19%pred, FVC 80±16%pred, DLCO 61±13%pred, DLCO/VA 91±16%pred). 3 patients needed post-interventional intensive care due to sedation hangover. Bleeding occurred in 7 (moderate) and 8 patients (severe, BTS 2013 classification) and could be stopped with Xylometazoline or Adrenaline. In 5 patients a pneumothorax occurred (4 of them with drainage need). In 2 patients myocardial infarction developed after >24 hours, confirmed via coronary angiography and apparently being a primary manifestation of coronary heart disease. 1 patient died of acute ILD exacerbation (histologically probable UIP pattern). Considering previous data mortality after TCB is 0.7%, after surgical lung biopsy 3.3%
Conclusion: Until now, TCB in IIP patients is still being established in clinical routine. There is probably a relevant procedure-associated risk despite of sufficient lung functional reserve. Currently, a risk constellation for the occurrence of complications cannot be identified. Mortality after TCB is probably lower than after surgical lung biopsy.
- Copyright ©ERS 2015