FOB is a valuable tool in the evaluation and management of patients with pulmonary disorders. Bleeding complications tend to be increased in RF patients due to coagulation abnormalities and platelet dysfunction.
To evaluate the incidence of complications and the diagnostic yield of FOB in patients with and without RF.
A retrospective chart review of all the pts that had RF and underwent FOB from January 2000 to January 2001 was done; a control group of patients during that same time period with no RF was included. Patients with abnormal coagulation profile or liver function test were excluded.
50 patients, 14 in the RF and 36 in the non-RF group were reviewed. Bleeding (>100cc) was seen only in pts where TBbx was done; the 2 pts in the RF group had a creat >4. Thirtheen pts in the RF and 28 in the non RF-group had FOB as part of a work up for lung infiltrate or mass; the diagnostic yield was 38% (5/13) and 46% (13/28) in the RF and non-RF group, respectively.CONCLUSIONS: Our study indicates there may be an increased tendency for significant bleeding from TBbx in pts with RF.CLINICAL IMPLICATIONS: Awareness of this risk is important as FOB plays a pivotal role in the evaluation of patients with lung disease. FOB with BAL seems to be a safe procedure in patients.with RF. Despite the small sample we still recommend the use of TBbx when the benefits outweigh the risks of the procedure.
Complications of FOBFOBTransbronchial Biopsy(TBbx)/ Bronchoalveolar lavage(BAL)Transbronchial Biopsy (TBbx)/ Bronchoalveolar lavage (BAL) BleedingBAL aloneInspectionRF n=143/14 (21%)2/3 (66%)10/14 (71%)1/14 (8%)Non-RF n=3615/36 (42%)2/15 (13%)12/36 (34%)9/36 (25%)
G. Diaz-Fuentes, None.