Introducción: La criobiopsia pulmonar transbronquial (TBCB) se ha convertido en una alternativa diagnóstica a la biopsia pulmonar quirúrgica, principalmente en la enfermedad pulmonar intersticial. A pesar de su naturaleza menos invasiva y de un mayor rendimiento diagnóstico, se han descrito algunas complicaciones asociadas, como el neumotórax. En pocas oportunidades se ha comparado la TBCB y la biopsia transbronquial con fórceps (TBFB). El objetivo del presente estudio es evaluar la incidencia de neumotórax después de TBFB y TBCB y la necesidad de drenaje pleural.
Métodos: Estudio retrospectivo de pacientes que se sometieron a TBCB y TBFB, específicamente aquellos que desarrollaron neumotórax postoperatorio.
Resultados: Se realizaron un total de 181 biopsias pulmonares transbronquiales. Sesenta y tres (35%) fueron TBFB y 118 (65%) fueron TBCB. Tres pacientes en el grupo TBFB (5%) presentaron neumotórax postoperatorio, mientras que 16 pacientes (14%) presentaron neumotórax en el grupo TBCB (p 0,051). El análisis univariado reveló una asociación estadísticamente significativa entre el diagnóstico preoperatorio de fibrosis y un mayor riesgo de neumotórax postoperatorio después de TBCB (p 0.027), mientras que otras variables no arrojaron un resultado significativo.
Conclusión: Aunque se necesitan más estudios comparativos de alto volumen, este documento destaca la relevancia del neumotórax después de la TBCB. Esto deriva en una fuerte necesidad de protocolos de procedimientos claramente estandarizados para TBCB y una evaluación cuidadosa de sus complicaciones versus su rendimiento diagnóstico
Introduction: It has been proposed that exposure to pulmonary function tests (PFT) could be associated with a higher risk of viral transmission. The risk of the Coronavirus Disease 2019 (COVID-19) transmission after performing PFT is unknown. We aimed to assess the incidence of COVID-19 after a PFT at an academic teaching facility in Buenos Aires, Argentina.
Materials and methods: We conducted a retrospective cohort study including all consecutive adult patients that performed PFT between April 1, 2020 and September 30, 2020. Patients with prior COVID-19 were excluded. We defined a 15-day time window to ascertain PFT related COVID-19. The primary outcome was ascertained by consulting a national database, which has information on all patients with nasopharyngeal swabs for SARS-CoV-2 in Argentina.
Results: We included 278 patients who performed a PFT. Fifty percent were women, the mean age was 54 years (SD 18), and the main comorbidities were obesity (31%), smoking (31%), hypertension (29%), and chronic lung disease (28%). The main indication for performing PFT was anesthetic preoperative risk assessment. Swabs were collected from 27 patients (10%). Twenty-two swabs (8%) were taken according to surgical protocols; five swabs (2%) were taken due to clinical suspicion of COVID-19, with only one testing positive. The cumulative incidence of COVID-19 after PFT was 0.36% (95% CI 0.01-20%). None of the technicians developed symptomatic disease.
Conclusion: Given the right setting and strict adherence to international recommendations, the SARS-CoV-2 infection after having a PFT appears to be low, which follows that these procedures can be performed safely for both patients and staff.
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