Interventional pulmonology procedures in the pediatric population

Abstract

We identified a cohort of pediatric patients that were able to successfully undergo diagnostic and therapeutic procedures under the direction of an experienced IP team. Cases included the evaluation and management of both malignant and benign complex airway and pleural diseases. There was no major morbidity or mortality related to our procedures, demonstrating an ability to safely evaluate and manage complex airway and pleural disease in the pediatric population.

A multicenter study on the utility and safety of EBUS‐TBNA and EUS‐B‐FNA in children

“…We also searched the references of the included studies and our personal files. We identified only eight studies (three original articles and five case reports; 44 subjects) that have described the use of EBUS‐TBNA/EUS‐FNA in the pediatric population (Table ) . All studies employed the adult EBUS scope for performing EBUS‐TBNA/EUS‐B‐FNA, except one study that used the EUS scope .…”

The use of convex probe endobronchial ultrasound-guided transbronchial needle aspiration in a pediatric population: A multicenter study

“…These authors believe that direct visualization of the subcarinal space by EBUS may have allowed for safe needle aspiration of this lymph node station. We have previously published data supporting the integration of interventional pulmonologists within the multidisciplinary care of pediatric patients and within this data we present the successful use of EBUS‐TBNA in 12 patients from a single institution of patients under the age of 20 …”

“…The use of conventional TBNA remains a skill taught to adult pulmonologists during fellowship training and will be available at most institutions. Another option may include the use of radial probe ultrasound for lymph node localization prior to TBNA, however the data for this method in the pediatric population remains quite limited . The ability to obtain access to intrathoracic abnormalities via endoscopy has always been limited by the requirement that lesions be located within or adjacent to the airway.…”

“…We have previously published data supporting the integration of interventional pulmonologists within the multidisciplinary care of pediatric patients and within this data we present the successful use of EBUS-TBNA in 12 patients from a single institution of patients under the age of 20. 18 It appears the use of EBUS-TBNA remains underutilized in patients of younger age. This has also been confirmed with a recent review of the AQuIRE data as previously presented by Yarmus et al 19 noting only four patients (out of a total of 1,299 patients) under the age of 21 undergoing EBUS-TBNA, with all four procedures obtaining adequate tissue sampling (data not shown).…”

“…Another option may include the use of radial probe ultrasound for lymph node localization prior to TBNA, 12 however the data for this method in the pediatric population remains quite limited. 18 The ability to obtain access to intrathoracic abnormalities via endoscopy has always been limited by the requirement that lesions be located within or adjacent to the airway. In order to obtain an adequate ultrasound image, soft tissue or fluid (such as a blood vessel) must be present between the airway wall and the lesion.…”