Prophylactic Hemostatic Treatment to Control Iatrogenic Bleeding During Endobronchial Biopsy (PROTECT Study): A...

Area of Science:

• Pulmonology
• Gastroenterology
• Interventional Endoscopy

Background:

• Iatrogenic bleeding during endobronchial biopsy can be severe and life-threatening.
• Existing guidelines suggest prophylactic hemostatic agents, but clinical evidence remains limited.

Purpose of the Study:

• To evaluate the efficacy of prophylactic hemostatic treatment in controlling bleeding during endobronchial biopsy.

Main Methods:

• A multicenter, randomized, placebo-controlled trial involving 462 participants undergoing endobronchial biopsy.
• Participants were randomized to receive adrenaline, ice-cold saline, or saline (placebo).
• Primary outcomes included the Bleeding Severity Scale and Visual Analogue Scale.

Main Results:

• Prophylactic hemostasis did not significantly improve bleeding severity compared to placebo.
• A trend towards reduced bleeding was observed with ice-cold saline in patients younger than 65 years (RR 0.90 [95% CI 0.82-0.99], p=0.04).
• Prophylactic hemostasis was demonstrated to be safe.

Conclusions:

• Prophylactic hemostasis did not show significant improvement in biopsy-related bleeding.
• A potential benefit of prophylactic hemostasis was noted in younger patients (<65 years), suggesting a need for further research.