In an attempt to decrease pneumothorax after transthoracic needle lung biopsy we evaluated the effect of breathing 100% oxygen during the procedure. Fifty consecutive biopsies on 46 hospital patients were performed on subjects breathing either oxygen or compressed air. The selected gas, chosen randomly, was given for five minutes before the biopsy and continued for 30 minutes after. Twenty-six procedures were on air (group 1) and 24 on pure oxygen (group 2). Four subjects in group 2 were eliminated from analysis because they were unable to sustain the required oxygen breathing. Results showed fewer pneumothoraces with subjects breathing oxygen (four out of 20) than with those breathing air (11 out of 26). Three patients in group 1 required chest tube drainage for symptoms of dyspnoea, but none were required in group 2. The peak area of gas accumulation for each pneumothorax was smaller in group 2, with a mean surface area of 27·1 cm2 (range 9·6-63·8), than in group 1 mean of 68·1 cm2 (range 6·4-172·4). The rather surprising finding of fewer pneumothoraces in the oxygen group may be explained by rapid absorption of small leaks immediately after lung puncture. These results were statistically significant (p<0·05). We conclude that 100% oxygen breathing during transthoracic needle biopsy decreases the number and size of pneumothoraces and propose this simple technique to decrease the morbidity of transthoracic needle lung biopsy.
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