Technique and use of transbronchial biopsy in children and adolescents.

Abstract:

: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%).

journal_name

Pediatr Pulmonol

journal_title

Pediatric pulmonology

authors

Whitehead B,Scott JP,Helms P,Malone M,Macrae D,Higenbottam TW,Smyth RL,Wallwork J,Elliott M,de Leval M

doi

10.1002/ppul.1950120408

subject

Has Abstract

pub_date

1992-04-01 00:00:00

pages

240-6

issue

4

eissn

8755-6863

issn

1099-0496

journal_volume

12

pub_type

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