TY - JOUR T1 - Lung cancer tissue diagnosis in poor lung function: addressing the ongoing percutaneous lung biopsy FEV<sub>1</sub> paradox using Heimlich valve JF - Thorax JO - Thorax SP - 757 LP - 758 DO - 10.1136/thoraxjnl-2016-208381 VL - 71 IS - 8 AU - R Abdullah AU - A N Tavare AU - A Creamer AU - D Creer AU - R Vancheeswaran AU - S S Hare Y1 - 2016/08/01 UR - http://thorax.bmj.com/content/71/8/757.abstract N2 - Many centres continue to decline percutaneous lung biopsy (PLB) in patients with poor lung function (particularly FEV1 &lt;1 L) due to the theoretically increased risk of pneumothorax. This practice limits access to novel lung cancer therapies and minimally invasive surgical techniques. Our retrospective single-centre analysis of 212 patients undergoing PLB, all performed prospectively and blinded to lung function, demonstrates that using ambulatory Heimlich valve chest drain (HVCD) to treat significant postbiopsy pneumothorax facilitates safe, diagnostic, early discharge lung biopsy irrespective of lung function with neither FEV1 &lt;1 L nor transfer coefficient for carbon monoxide (TLCO) &lt;40% predicted shown to be independent predictors of HVCD insertion or pneumothorax outcomes. Incorporating ambulatory HVCD into standard PLB practice thereby elegantly bridges the gap that currently exists between tissue diagnosis in patients with poor lung function and the advanced therapeutic options available for this cohort. ER -