Time required to obtain endobronchial biopsies in children during fiberoptic bronchoscopy.
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.
Regamey
Nicolas
N
Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom. nicolas.regamey@insel.ch
Balfour-Lynn
Ian
I
Rosenthal
Mark
M
Hogg
Claire
C
Bush
Andrew
A
Davies
Jane C
JC
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