RT Journal Article SR Electronic T1 Feasibility of transbronchial lung cryobiopsy in patients with veno-venous extracorporeal membrane oxygenation support JF ERJ Open Research JO erjor FD European Respiratory Society SP 00383-2022 DO 10.1183/23120541.00383-2022 A1 Shiyao Wang A1 Yingying Feng A1 Yi Zhang A1 Ye Tian A1 Sichao Gu A1 Xiaojing Wu A1 Meiyuan Li A1 Yiming Feng A1 Dan Wang A1 Ying Li A1 Zheng Tian A1 Ling Zhao A1 Min Li A1 Wenhui Chen A1 Xu Huang A1 Guowu Zhou A1 Qingyuan Zhan YR 2022 UL http://openres.ersjournals.com/content/early/2022/09/22/23120541.00383-2022.abstract AB Background Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is essential life support in patients with severe acute hypoxemic respiratory failure. However, biopsies should be considered for some patients with unknown etiology. This study aims to evaluate the feasibility of transbronchial lung cryobiopsy (TBLC) in such patients.Methods All patients with acute hypoxemic respiratory failure of unknown etiology who underwent TBLC with VV-ECMO support were retrospectively reviewed. Patients’ characteristics, ventilation settings, procedure parameters, complications, pathological diagnosis, and survival were summarised and analysed.Results Eight female and five male patients with VV-ECMO support underwent TBLC. The median age was 58 (IQR 38–67) years old. Concurrent diseases were present in 10 of the 13 patients, seven of which were immunosuppressed. The median time between biopsy and VV-ECMO establishment was 2.0 (IQR 0.5–6.5) days. No patient died from the procedure. Neither pneumothorax nor severe bleeding occurred in any of the patients. Five of the 13 patients experienced moderate bleeding, and all bleeding events were successfully controlled with prophylactic balloon blockers. Pathological diagnosis by TBLC was obtained in all patients. And the diagnosis of diffuse alveolar damage (DAD) was made in nine of them.Conclusions In patients with VV-ECMO support, the TBLC procedure is generally safe when standardised bleeding prophylaxis is in place. TBLC is contributive to identifying underlying etiologies in patients with acute hypoxemic respiratory failure of unknown etiology.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: All the authors state that there are no conflicts of interest related to this study.