Dominic Thomas Keating, John Taverner
European Respiratory Journal 2023 61: 2201942; DOI: 10.1183/13993003.01942-2022
Development of transbronchial lung cryobiopsy (TBLC) technology was inspired by the Joule–Thomson principle, where rapid freezing occurs with the sudden expansion of certain gases as they move from a high-pressure to a low-pressure environment. Harnessing this phenomenon in a catheter tip which has the flexibility to be manoeuvred into awkward positions via flexible bronchoscope allows peripheral lung tissue to be sampled. The diagnostic and therapeutic capabilities of flexible bronchoscopy have expanded considerably since its first use by Sanderson et al. [1] for the cryoablation of an endobronchial tumour; bronchoscopic cryosurgery has evolved to include cryoablation, cryoadhesion and cryobiopsy.
Transbronchial lung cryobiopsy increased diagnostic yield in mechanically ventilated post-lung transplant recipients in a single centre study, with a reasonable safety profile. Long-term outcomes resulting from improved yield still need to be assessed. http://bit.ly/3EpPU5Y
Conflict of interest: All authors have nothing to disclose.