Sistema de Salut de Catalunya
Institut Català de la Salut
[Schramm D, Freitag N] Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany. [Kötz K] Queen Silvias Children Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden. [Iglesias-Serrano I] Unitat de Pneumologia Pediàtrica i Fibrosi Quística, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Culebras-Amigo M] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Koblizek V] Department of Pneumology, University Hospital Hradec Kralove, Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czechia
Vall d'Hebron Barcelona Hospital Campus
2023-01-17T07:23:57Z
2023-01-17T07:23:57Z
2022-11
Airway obstruction; Cryobiopsy; Paediatric bronchoscopy
Obstrucción de las vías respiratorias; Criobiopsia; Broncoscopia pediátrica
Obstrucció de les vies respiratòries; Criobiòpsia; Broncoscòpia pediàtrica
Background and objective Cryotherapy in interventional bronchoscopy is a new treatment modality, which has recently been made available for the paediatric airway. Lack of experience and safety concerns have led to hesitant adaptation. The aim of this study was to assess indications, success rates and complications of airway cryotherapy in children. Methods Bronchoscopists from medical centre performing cryotherapy in patients between 0 and 18 years were invited to participate in a prospective study based on an online questionnaire. Patient and participant data were collected between June 2020 and June 2021. Results A total of 69 cryotherapy procedures were performed in 57 patients a for three main indications: Biopsy (30), restoration of airway patency (23) and foreign body aspiration (16). The overall success rate was 93%, the remaining 7% were performed for foreign body removal and required a switch of technique. Restoration of airway patency was successfully applied in various pathologies, including mucus plugs, bronchial casts and post traumatic stenosis. The diagnostic yield of transbronchial biopsies was 96%. No severe complications were encountered; one pneumothorax following a cryobiopsy required a chest drain for 48 h. No child was admitted to intensive care or died from a procedural complication. Conclusion In this largest paediatric case collection to date, cryotherapy was safe and carried a high success rate. Cryobiopsy compares favourably to the widely used forceps biopsy and could replace it in the future. Paediatric bronchoscopists are encouraged to add cryotherapy to their armamentarium of airway interventions.
Open Access funding enabled and organized by Projekt DEAL.
Article
Published version
English
Bronquis; Broncoscòpia; Fred - Ús terapèutic; Infants; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Cryotherapy; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Respiratory System::Bronchoscopy; NAMED GROUPS::Persons::Age Groups::Child; ANATOMY::Respiratory System::Lung::Bronchi; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::crioterapia; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::técnicas diagnósticas respiratorias::broncoscopia; DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::niño; ANATOMÍA::sistema respiratorio::pulmón::bronquios
Wiley
Respirology;27(11)
https://doi.org/10.1111/resp.14353
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
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