Lung Biopsy

The initial management of patients with acute pulmonary infiltrates and respiratory failure is an area of much deliberation within the environment of the ICU. Patients are often treated with empirical antimicrobial medications. These may be added in the setting of existing corticosteroid and/or other immunosuppressive medications. The open lung biopsy can direct the withdrawal of […]

Canver and Mentzer looked specifically at ventilator-dependent patients with diffuse idiopathic lung disease. They included interstitial pneumonitis and fibrosis as well as alveolitis as a specific diagnosis, thus recording a 100% specific diagnosis rate. A change in therapy was initiated in 67% of patients, a rate similar to the one used in this study. Overall […]

Open lung biopsy established a specific diagnosis in 46% of the patients in this series, all of whom were critically ill and with ventilator-dependent respiratory failure. As a result of the findings from the open lung biopsy, alteration in therapy (including withdrawal of therapy) occurred in 75% of the patients, and of these, 39% survived. […]

Five patients (21%) had documented intraoperative complications. Four patients had documented hypoxia (defined as arterial oxygen saturation < 90%), and one patient had hypotension requiring the introduction of inotropes. Postoperative complications occurred in 17% of the subjects. All such patients had persistent air leaks. One also had excessive postoperative bleeding, requiring an emergency reoperation for […]

All patients were receiving antimicrobial medications before the open lung biopsy. Seventeen patients (71%) were immunosuppressed at the time of the open lung biopsy. The median number of other organ failures was one other organ. The mean Pa02/ fraction of inspired oxygen (F102) ratio before open lung biopsy for this group of patients was 161, […]

The information obtained included the following: demographic data, data taken before (Table 1) and after (Table 2) open lung biopsy, open lung biopsy histological diagnosis, open lung biopsy-initiated treatment changes and resultant outcome, cause of death, and hospital outcome. The extent of organ failure, other than respiratory, at the time leading up to open lung […]

The desire to obtain a definitive diagnosis to optimize medical treatment has increased the demand for early, more invasive, and costly investigative procedures. Open lung biopsy is regarded as the gold standard for the diagnosis of pulmonary infiltrates, and several studies have documented its use in specific patient populations. A complete history, physical examination, chest […]