Bf 1t180

Department of Respiratory Diseases, University Hospital Brno, Czech Republic, is a university-type facility concentrating the most difficult respiratory cases (i.e. patients with lung cancer, interstitial lung disease, cystic fibrosis etc.) from an area populated by ca 1.5 million inhabitants. Annually, cca. 1100–1300 bronchoscopic procedures are performed in the institution. Of these, cca. 250–300 patients annually undergo TBB. The most frequent indication for TBB include suspicion of lung cancer, differential diagnosis of interstitial lung disease and infiltrates of unknown significance present on chest radiograph or lung CT scan.
Flexible fiberoptic bronchoscopies were performed in light sedation (using 0.25 mg of alprazolam or 3.75 mg of midazolam) and using topical anesthetics (lidocaine and trimecaine or bupicavaine) in accordance with the 2013 British Thoracic Society (BTS) guidelines [3 (link)]. Flexible fiberoptic bronchoscopes type BF-1 T180 (Olympus, Japan) and EB-1975 K (Pentax Medical, Japan) were used. Fluoroscopically unguided TBB were performed in accordance with the BTS guidelines [3 (link)] using the 1.8 mm-diameter Single Use-Biopsy Forceps - type NBF12–11018120 (Micro-Tech, China).

Bronchofiberoscopy was performed according to the guidelines of the American Thoracic Society [64 (link)] using the bronchofiberoscope BF 1T180 (Olympus, Tokyo, Japan) with local anesthesia (2% lidocaine) and in mild sedation (0.05–0.1 mg fentanyl and 2.5–5 mg midazolam given intravenously). During that procedure, 2–3 endobronchial biopsies were taken from the right lower lobe (the carina between B9 and B10) together with the brush biopsy. Collected endobronchial specimens were immediately fixed in 10% neutral buffered formalin solution (Sigma-Aldrich, Saint Luis, MO, USA) and sent to the Pathology Department for further analysis. Brushes were immediately immersed in TRIzol Reagent (Thermo Fisher Scientific, Carlsbad, CA, USA).

Bronchofiberoscopy was performed according to the guidelines of the American Thoracic Society [68 (link)] using the bronchofiberoscope BF 1T180 (Olympus, Japan) with local anesthesia (2% lidocaine spray) and in mild sedation (0.05–0.1 mg fentanyl and 2.5–5 mg midazolam, both intravenous).
Endobronchial forceps biopsies were taken from the right lower lobe (the carina between B9 and B10) together with the bronchial brush biopsies (Boston Scientific, Marlborough, MA). The endobronchial specimens were immediately fixed in 10% neutral buffered formalin solution (Sigma-Aldrich, Saint Luis, MO, USA) and sent to the Pathology Department for further analysis. Brushes were immediately immersed in TRIzol lysis reagent to minimize RNA degradation and kept for further analysis (Thermo Fisher Scientific, Carlsbad, CA, USA).
BAL samples were centrifuged at 2000× g for 20 min. The supernatant was frozen in aliquots and stored at −70 °C until analysis.