Chest
Clinical Investigations in Critical CareThe Utility of Open Lung Biopsy in Patients Requiring Mechanical Ventilation
Section snippets
Materials and Methods
A retrospective review was conducted of medical case records of patients admitted to an adult university-affiliated tertiary referral ICU during the period of 1985 to 1995. Inclusion criteria were patients with ventilator-dependent respiratory failure and nonspecific radiological pulmonary interstitial infiltrates who had undergone open lung biopsy. This included patients already receiving mechanical ventilation and those admitted to the ICU for mechanical ventilation. Patients who had
Results
Open lung biopsy was an infrequently performed procedure with a yearly incidence of 0 to 0.9% of patient admissions to the ICU. Twenty-four patients were identified who fulfilled the study criteria. The mean age (± SD) was 48.9 ± 16.1 years.
All patients were receiving antimicrobial medications before the open lung biopsy. Seventeen patients (71%) were immunosuppressed at the time of the open lung biopsy. The median number of other organ failures was one other organ. The mean pao2/fraction of
Discussion
Open lung biopsy established a specific diagnosis in 46% of the patients in this series, all of whom were critically ill and with ventilator-dependent respiratory failure. As a result of the findings from the open lung biopsy, alteration in therapy (including withdrawal of therapy) occurred in 75% of the patients, and of these, 39% survived. Another 11% benefited from the avoidance of unnecessary, prolonged, and futile therapy. No patient with ≥ 2 other organ failures benefited from an
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