• Joseph Cooley, Rick Balestra, Alejandro A Aragaki-Nakahodo, Danielle N Caudell Stamper, Thitiwat Sriprasart, Zulma Swank, Robert P Baughman, and Sadia Benzaquen.
• Department of Internal Medicine, University of Cincinnati Medical Center, USA. Electronic address: cooleyjc@ucmail.uc.edu.
• Respir Med. 2018 Jul 1; 140: 71-76.

IntroductionTransbronchial lung cryobiopsy (TBLC) has become a popular option for tissue diagnosis of interstitial lung disease (ILD), however reports vary regarding the safety of this procedure. Herein, we evaluate the safety of transbronchial cryobiopsy in hospitalized patients, comparing adverse events to outpatient procedures.Methods And MeasurementsThis is a single center, retrospective chart review of all TBLC performed for suspected ILD between November 2013 and March 2017. Biopsies were performed by a board certified interventional pulmonologist or interventional pulmonology fellow using a two-scope technique.ResultsOne hundred fifty-nine cryobiopsies were performed for the diagnosis of ILD. Rates of adverse events are as follows: pneumothorax 11%, persistent air leak 1.3%, moderate-severe bleeding 3.8%, ICU transfer within 48 h 3.1%, and all cause 30-day mortality 1.9%. No deaths were attributed to the procedure. Comparing adverse events between hospitalized patients and outpatients, rates of pneumothorax were 24% vs 9.9%, persistent air leak 5.9% vs 0.7%, ICU transfer 12% vs 2.1%, and 30-day mortality 5.9% vs 1.4%. However, no differences were statistically significant.ConclusionPractitioners should recognize that while cryobiopsies are a high-yield, safe, and cost-effective alternative to surgical lung biopsy, not all procedures carry the same risk profiles. Hospitalized patients may have a greater propensity for pneumothorax, persistent air leak, transfer to the ICU, and 30-day mortality.Published by Elsevier Ltd.

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