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Technique and use of transbronchial biopsy in children and adolescents
Author(s) -
Whitehead B.,
Scott P. J.,
Helms P.,
Malone M.,
Macrae D.,
Higenbottam T. W.,
Smyth R. L.,
Wallwork J.,
Elliott M.,
De Leval M.
Publication year - 1992
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950120408
Subject(s) - medicine , bronchoalveolar lavage , pneumothorax , candida albicans , lung , bronchoscopy , biopsy , surgery , gastroenterology , biology , genetics
Since July 1988, a total of 92 transbronchial biopsies (TBB) have been performed in 18 patients (aged 3–16 years). Twelve patients (67%) were heart‐lung transplant (HLT) recipients undergoing surveillance for pulmonary graft rejection and infection. The remainder included immunocompromised patients at risk of opportunistic infections (n = 4), patients with fibrosing alveolitis (n = 1) and a collagen vascular disorder with suspected lung involvement (n = 1). TBB was performed through either a fiberoptic (n = 50) or a rigid (n = 41) bronchoscope, all under general anesthesia. On one occasion a cardiac bioptome was used through an endotracheal stent. The sensitivity of TBB for diagnosing acute and chronic rejection in HLT patients was 88% and 60%, respectively (specificity, 91% and 100%). Definitive diagnoses were made in 4 (67%) of the non‐HLT group. Bronchoalveolar lavage (BAL) was performed during each procedure for microbiological and cytological examination. Thirty‐four pathogenic organisms including Pseudomonas aeruginosa (16/34), Staphylococcus aureus (8/34), and Candida albicans (5/34) were isolated from BAL culture. Complications included pneumothorax (8%), transient pyrexia (7%), and dyspnea (2%).