RT Journal Article
SR Electronic
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
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 757
OP 758
DO 10.1136/thoraxjnl-2016-208381
VO 71
IS 8
A1 R Abdullah
A1 A N Tavare
A1 A Creamer
A1 D Creer
A1 R Vancheeswaran
A1 S S Hare
YR 2016
UL http://thorax.bmj.com/content/71/8/757.abstract
AB 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.