ArticleJournal of bronchology & interventional pulmonology2024
High Tidal Volume, High Positive End Expiratory Pressure and Apneic Breath Hold Strategies (Lung Navigation Ventilation Protocol) With Cone Beam Computed Tomography Bronchoscopic Biopsy of Peripheral Lung Lesions: Results in 100 Patients.
Article in Journal of bronchology & interventional pulmonology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Anaesthesia for diagnostic and therapeutic bronchoscopy.BJA education · 2026Review
- From "shooting in the dark" to "precision hit": Technological evolution, synergistic strategies, and future paths for peripheral pulmonary nodule diagnosis.Chinese medical journal pulmonary and critical care medicine · 2026Article
- Standardized anesthetic and ventilation protocol to prevent atelectasis during robotic-assisted bronchoscopy: retrospective observational study.BMC anesthesiology · 2026Observational
- Best practices in shape-sensing robotic bronchoscopy with mobile cone beam computed tomography guidance: how I do it.Journal of thoracic disease · 2026Review
- Intraprocedural O-arm computed tomography-guided navigation with ventilatory strategy for atelectasis electromagnetic navigation bronchoscopic biopsy of peripheral lung lesions: an IDEAL stage 2a study.Journal of thoracic disease · 2025Article
- Apneic oxygenation during robotic-assisted bronchoscopy: a retrospective study on safety and diagnostic yield.Journal of thoracic disease · 2025Article
- Efficacy and safety of cone-beam computed tomography-guided bronchoscopy for peripheral pulmonary lesions: a systematic review and meta-analysis.Journal of thoracic disease · 2025Article
- Cone Beam Computed Tomography-Guided Navigation Bronchoscopy with Augmented Fluoroscopy for the Diagnosis of Peripheral Pulmonary Nodules: A Step-by-Step Guide.Respiration; international review of thoracic diseases · 2025Article
- Severity of Atelectasis during Bronchoscopy: Descriptions of a New Grading System (Diagnostics (Basel, Switzerland) · 2024Article
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Abstract
backgroundA dedicated anesthesia protocol for bronchoscopic lung biopsy-lung navigation ventilation protocol (LNVP)-specifically designed to mitigate atelectasis and reduce unnecessary respiratory motion, has been recently described. LNVP demonstrated significantly reduced dependent ground glass, sublobar/lobar atelectasis, and atelectasis obscuring target lesions compared with conventional ventilation.
methodsIn this retrospective, single-center study, we examine the impact of LNVP on 100 consecutive patients during peripheral lung lesion biopsy. We report the incidence of atelectasis using cone beam computed tomography imaging, observed ventilatory findings, anesthesia medications, and outcomes, including diagnostic yield, radiation exposure, and complications.
resultsAtelectasis was observed in a minority of subjects: ground glass opacity atelectasis was seen in 30 patients by reader 1 (28%) and in 18 patients by reader 2 (17%), with good agreement between readers (κ = 0.78). Sublobar/lobar atelectasis was observed in 23 patients by reader 1 and 26 patients by reader 2, also demonstrating good agreement (κ = 0.67). Atelectasis obscured target lesions in very few cases: 0 patients (0%, reader 1) and 3 patients (3%, reader 2). Diagnostic yield was 85.9% based on the AQuIRE definition. Pathology demonstrated 57 of 106 lesions (54%) were malignant, 34 lesions (32%) were benign, and 15 lesions (14%) were nondiagnostic.
conclusionCone beam computed tomography images confirmed low rates of atelectasis, high tool-in-lesion confirmation rate, and high diagnostic yield. LNVP has a similar safety profile to conventional bronchoscopy. Most patients will require intravenous fluid and vasopressor support. Further study of LNVP and other ventilation protocols are necessary to understand the impact of ventilation protocols on bronchoscopic peripheral lung biopsy.
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