Does open lung biopsy affect treatment in patients with diffuse pulmonary infiltrates?

Walker, W. Allan; Cole, Francis H.; Khandekar, Alim; Mahfood, Saade; Watson, Donald C.

doi:10.1016/s0022-5223(19)34543-x

Cited by 43 publications

(24 citation statements)

References 10 publications

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“…The decision to perform OLB in patients on mechanical ventilation is made based on the need to obtain a precise diagnosis and therefore offer specific treatment (avoiding the harmful effects or inefficiency of empirical treatment) or even on the desire to obtain prognostic information (4,6) . There is no consensus regarding the timing of the OLB (4,7,8) . The biopsy site should be determined based on the radiological findings so that only a small fragment need be collected (9,10) .…”

Section: Discussionmentioning

confidence: 99%

“…For the diagnosis of diffuse pulmonary infiltrate, OLB is regarded as the gold standard (1,4,(7)(8)(9)17) . In the literature, its positivity varies from 80% to 94%, whereas that of procedures using fiberoptic bronchoscopy (bronchoalveolar lavage, bronchial brush and transbronchial biopsy) ranges from 38% to 85% (4).…”

Section: Discussionmentioning

confidence: 99%

“…Atelectasis, bronchopleural fistula, empyema and hemothorax have all been associated with OLB (1,4,(7)(8)(9) . Five of our patients (20.8%) presented such complications, bronchopleural fistula being the most common (4 cases).…”

Section: Discussionmentioning

confidence: 99%

“…Being on mechanical ventilation does not seem to increase the frequency of complications. In the studies reviewed, in which patients with diffuse pulmonary infiltrate and not on mechanical ventilation were submitted to OLB and subsequently evaluated, complications were observed in less than 18% (8,(23)(24)(25)(26) . Most patients who presented complications were diagnosed with ARDS.…”

Section: Discussionmentioning

confidence: 99%

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Biópsia pulmonar a céu aberto em pacientes sob ventilação mecânica e com infiltrado pulmonar difuso

Monteiro¹,

Addor²,

Nigri³

et al. 2005

J. bras. pneumol.

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INTRODUÇÃO: A biópsia pulmonar a céu aberto é considerada o padrão ouro no diagnóstico dos infiltrados pulmonares difusos. OBJETIVO: Avaliar positividade diagnóstica, mudanças no tratamento, complicações e mortalidade de pacientes em ventilação mecânica, com infiltrado pulmonar difuso e que foram submetidos a biópsia pulmonar a céu aberto. MÉTODO: Foram revisados, retrospectivamente, os prontuários de 24 pacientes, com idades entre 26 e 89 anos, internados no centro de tratamento intensivo de dois hospitais privados, submetidos a biópsia pulmonar a céu aberto. RESULTADOS: Encontrou-se 100% de positividade diagnóstica, sendo que em 75% dos casos houve mudança na terapêutica. Cinco pacientes apresentaram complicações relacionadas ao procedimento (20,8%). Não houve óbito diretamente relacionado à biópsia. A mortalidade global foi de 45,8%. CONCLUSÃO: A biópsia pulmonar a céu aberto é um procedimento seguro e com alta positividade, que pode ser utilizado no diagnóstico de infiltrado pulmonar difuso em pacientes sob ventilação mecânica. Apesar de seu impacto na mortalidade desses pacientes ainda não estar estabelecido na literatura, suas informações relacionadas ao prognóstico também devem ser consideradas.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Biópsia pulmonar a céu aberto em pacientes sob ventilação mecânica e com infiltrado pulmonar difuso

Monteiro¹,

Addor²,

Nigri³

et al. 2005

J. bras. pneumol.

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“…Several retrospective studies addressing these issues in series of patients with a variety of diffuse parenchymal diseases are available. [81][82][83][84][85][86][87][88][89][90][91][92] In selected reports, the results have been very heterogeneous: the diagnostic yield ranged from 34 to 100%; therapy was altered in 46 to 75% of the cases. This heterogeneity may stem from several factors, including the selection of candidates for open-lung biopsy, the timing of the procedure along the course of the disease, and the expertise of the attending pathologist.…”

Section: Surgical Lung Biopsymentioning

confidence: 99%

Myths and Controversies in Hypersensitivity Pneumonitis

Lacasse¹,

Assayag²,

Cormier³

2008

Semin Respir Crit Care Med

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Hypersensitivity pneumonitis (HP) is a pulmonary disease with symptoms of dyspnea and cough resulting from the inhalation of an antigen to which the patient has been previously sensitized. HP is an orphan disease, and current concepts on its diagnosis and management are often outdated. The objectives of this review are to summarize the modern evidence regarding the diagnostic criteria of HP, its pathophysiology, the procedures involved in the management of the disease, and its treatment strategies. Several areas for further research are identified, with priority given to (1) the establishment of a multicenter collaborative network to enhance the recognition, diagnosis, and management of the disease; (2) the development and support of population-based studies to provide additional insights into environmental and clinical characterization of HP; and (3) the exploration of the use and validity of biomarkers of both exposure and disease.

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Diffuse Lung Disease

Lacasse¹,

Cormier²

2005

Evidence‐based Respiratory Medicine

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Does open lung biopsy affect treatment in patients with diffuse pulmonary infiltrates?

Cited by 43 publications

References 10 publications

Biópsia pulmonar a céu aberto em pacientes sob ventilação mecânica e com infiltrado pulmonar difuso

Biópsia pulmonar a céu aberto em pacientes sob ventilação mecânica e com infiltrado pulmonar difuso

Myths and Controversies in Hypersensitivity Pneumonitis

Diffuse Lung Disease

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