title: Time required to obtain endobronchial biopsies in children during fiberoptic bronchoscopy.
abstract: BACKGROUND
  Endobronchial biopsies are an important tool for the study of airway remodeling in children. We aimed to evaluate the impact of performing endobronchial biopsies as a part of fiberoptic bronchoscopy on the length of the procedure.
  
  
  METHODS
  Clinically indicated fiberoptic bronchoscopy at which endobronchial biopsy was attempted as a part of a research protocol was performed in 40 children (median age 6 years, range 2 months-16 years). Time needed for airway inspection, bronchoalveolar lavage (BAL) with three aliquots of 1 ml/kg of 0.9% saline, sampling of three macroscopically adequate biopsies, teaching, and other interventions (e.g., removal of plugs) was recorded. The bronchoscopist was not aware that the procedure was being timed.
  
  
  RESULTS
  Median (range) duration (min) was 2.5 (1.0-8.2) for airway inspection, 2.8 (1.7-9.4) for BAL, 5.3 (2.5-16.6) for biopsy sampling, 2.4 (1.5-6.6) for teaching and 4.1 (0.8-18.5) for other interventions. Three adequate biopsies were obtained in 33 (83%) children. Use of 2.0 mm biopsy forceps (via 4.0 and 4.9 mm bronchoscopes) rather than 1.0 mm (via 2.8 and 3.6 mm bronchoscopes) significantly reduced biopsy time (4.6 min vs. 8.4 min, P < 0.001).
  
  
  CONCLUSIONS
  It takes a median of just over 5 min to obtain three endobronchial biopsies in children, which we consider an acceptable increase in the duration of fiberoptic bronchoscopy for the purpose of research.
authors.affiliation: Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom. nicolas.regamey@insel.ch
authors.forename: Nicolas
authors.initials: N
authors.lastname: Regamey
authors.forename: Ian
authors.initials: I
authors.lastname: Balfour-Lynn
authors.forename: Mark
authors.initials: M
authors.lastname: Rosenthal
authors.forename: Claire
authors.initials: C
authors.lastname: Hogg
authors.forename: Andrew
authors.initials: A
authors.lastname: Bush
authors.forename: Jane C
authors.initials: JC
authors.lastname: Davies
mesh_terms: D001706:Biopsy; D001980:Bronchi / Q000473:pathology*; D001982:Bronchial Diseases / Q000473:pathology*; D018893:Bronchoalveolar Lavage; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013997:Time Factors