TY - JOUR T1 - Lung ultrasound assessment for pneumothorax following transbronchial lung cryobiopsy JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00045-2021 SP - 00045-2021 AU - Christian B. Laursen AU - Pia Iben Pietersen AU - Niels Jacobsen AU - Casper Falster AU - Amanda Dandanell Juul AU - Jesper Rømhild Davidsen Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2021/03/26/23120541.00045-2021.abstract N2 - Background Iatrogenic pneumothorax is a common and clinically important transbronchial cryobiopsy (TBCB) complication. A study was conducted to assess the diagnostic accuracy and clinical impact of immediate postprocedure lung ultrasound for diagnosing iatrogenic pneumothorax in patients suspected of interstitial lung disease (ILD) undergoing TBCB.Study design and methods In patients undergoing TBCB due to suspected ILD, LUS of the anterior surface of the chest was performed immediately after the TBCB procedure prior to extubation. Presence of lung point was used as a definite sign of pneumothorax. Chest X-ray (CXR) performed routinely 2 h after TBCB was used as reference standard.Results A total of 141 consecutive patients were included. Postprocedure LUS identified definite pneumothorax in 5 patients (3.6%)(95%CI: 1.5–8.3%). 2-hour CXR identified 19 patients (13.5%)(95%CI: 8.7–20.2%) with pneumothorax following TBCB. The diagnostic accuracy of LUS for diagnosing pneumothorax was: sensitivity 21.1% (95% CI: 6.1–45.6%), specificity 99.2% (95% CI: 95.5–100.0%), positive predictive value 80.0% (95%CI: 28.4–99.5%), and negative predictive value 89.0% (95%CI: 82.5–93.7%). Postprocedure LUS had a clinical impact in 5 patients (3.6%) (95%CI: 1.5–8.3), in which 4 had pleural drain inserted prior to extubation and 1 patient had prolonged observation prior to extubation.Interpretation LUS performed immediately following TBCB have a clinical impact by identifying patients with pneumothorax in need of immediate treatment prior to extubation, and to monitor pneumothorax size during in the operating room. Supplementary imaging prior to patient discharge is however still needed since the majority of pneumothoraxes develop later in the postprocedure period.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Laursen has nothing to disclose.Conflict of interest: Dr. Pietersen has nothing to disclose.Conflict of interest: Dr. Jacobsen has nothing to disclose.Conflict of interest: Dr. Falster has nothing to disclose.Conflict of interest: Dr. Juul has nothing to disclose.Conflict of interest: J.R. Davidsen reports financial support to attend the ERS International Congress and personal fees for teaching from Roche and Boehringer Ingelheim, and personal fees for teaching from Chiesi, outside the submitted work. ER -