The utility of open lung biopsy in patients requiring mechanical ventilation
| dc.contributor.author | Flabouris, A. | |
| dc.contributor.author | Myburgh, J. | |
| dc.date.issued | 1999 | |
| dc.description.abstract | <h4>Study objective</h4>To determine the diagnostic yield, morbidity, mortality, and therapeutic impact of the open lung biopsy in patients requiring mechanical ventilation.<h4>Design</h4>Retrospective review of patient records.<h4>Setting</h4>Tertiary ICU.<h4>Patients</h4>Patients with respiratory failure and diffuse pulmonary infiltrates requiring mechanical ventilation, leading up to or following an open lung biopsy.<h4>Measurements</h4>Information included patient demographics, organ failure, microbiological results before open-lung biopsy, Pao,/fraction of inspired oxygen values before and after biopsy, immunosuppression, timing of open lung biopsy, biopsy-related morbidity and mortality, duration of after-biopsy ventilation, open lung biopsy results, biopsy-initiated treatment alterations, and hospital outcome.<h4>Results</h4>Twenty-four patients were identified. The mean age was 48.9 years (confidence interval, 42.1 to 55.7). Twenty-one percent had respiratory infections diagnosed before open lung biopsy but not confirmed by open lung biopsy. Intraoperative complications occurred in 21% of patients, and postoperative complications occurred in 17% of patients. Operative mortality was 8.4%. The specific and the nonspecific diagnostic rates were both 46%. Lung histology was normal in two patients; one of those patients had a false-negative finding. No patient with respiratory failure plus 2 2 other organ failures survived. Alteration of therapy did not differentiate between survivors. Open lung biopsy-guided alteration of therapy directly benefited 39%, and withdrawal was possible in 8.4% of the patients.<h4>Conclusions</h4>The multiple organ dysfunction score should be considered when deciding the relative risk of performing an open lung biopsy, which in this group of patients provided a specific diagnosis in 46% and carried a mortality rate of 8.4%. | |
| dc.identifier.citation | Chest, 1999; 115(3):811-817 | |
| dc.identifier.doi | 10.1378/chest.115.3.811 | |
| dc.identifier.issn | 0012-3692 | |
| dc.identifier.issn | 1931-3543 | |
| dc.identifier.orcid | Flabouris, A. [0000-0002-1535-9441] | |
| dc.identifier.uri | http://hdl.handle.net/2440/5959 | |
| dc.language.iso | en | |
| dc.publisher | AMER COLL CHEST PHYSICIANS | |
| dc.source.uri | https://doi.org/10.1378/chest.115.3.811 | |
| dc.subject | Lung | |
| dc.subject | Humans | |
| dc.subject | Lung Diseases | |
| dc.subject | Respiratory Insufficiency | |
| dc.subject | Critical Illness | |
| dc.subject | Multiple Organ Failure | |
| dc.subject | Biopsy | |
| dc.subject | Respiration, Artificial | |
| dc.subject | Cause of Death | |
| dc.subject | Retrospective Studies | |
| dc.subject | Adult | |
| dc.subject | Aged | |
| dc.subject | Middle Aged | |
| dc.subject | Female | |
| dc.subject | Male | |
| dc.title | The utility of open lung biopsy in patients requiring mechanical ventilation | |
| dc.type | Journal article | |
| pubs.publication-status | Published |