Lung Biopsy Crucial in Diagnosing diffuse developmental disorder of lung in Pediatric Intensive Care

In a recent study published in the Pediatric Pulmonology found the critical role of lung biopsy in diagnosing critical lung conditions in pediatric intensive care units (ICUs). This investigation was conducted between 1995 and 2022 and majorly focused on the diagnostic yield of lung biopsies in 31 critically ill children. This provides valuable insights into the delicate balance between diagnostic necessity and the invasive nature of the procedure.

This study spanned over two decades involved children ranging from newborns to 10.8 years old who underwent lung biopsy in the ICU were examined thoroughly. The criteria for inclusion excluded biopsies conducted in operating rooms and post-mortem cases. Out of the 31 patients, majority (67.7%) were newborns who required invasive mechanical ventilation. Also, 70.9% were placed under extracorporeal membrane oxygenation (ECMO) and 89.7% had pulmonary hypertension.

The lung biopsy proved to be a diagnostic success in 81% of cases with reliability seemingly decreasing with age. The study identified diffuse developmental disorders of the lung as a primary diagnostic outcomes with alveolar capillary dysplasia and surfactant disorders. but, complications were observed in 29% of cases, with a significant association with ECMO usage, particularly showcasing a higher risk in cases extending beyond 10 days and in children over 2 years old.

The study underscores the significance of lung biopsy as a reliable diagnostic tool, specially in neonates who undergo critical situations with suspected diffuse developmental lung disorders. As the findings also highlight the complications linked to ECMO, this study calls paves way for a prospective evaluation of biopsy-related risks under ECMO, specially in prolonged cases and older children.

This research deepens the understanding of the diagnostic efficacy of lung biopsies in critical pediatric cases and also highlights the need for a nuanced approach that considers both diagnostic benefits and potential complications to optimize patient outcomes in intensive care settings.

Reference:

Levy, Y., Bitton, L., Sileo, C., Rambaud, J., Soreze, Y., Louvrier, C., Ducou le Pointe, H., Corvol, H., Hervieux, E., Irtan, S., Leger, P., Prévost, B., Coulomb L’Herminé, A., & Nathan, N. (2024). Lung biopsies in infants and children in critical care situation. In Pediatric Pulmonology. Wiley. https://doi.org/10.1002/ppul.26845