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Recent Advances in Chest Medicine |

Which Patients With ARDS Benefit From Lung Biopsy?Which Patients With ARDS Benefit From Lung Biopsy?

Jessica A. Palakshappa, MD; Nuala J. Meyer, MD, FCCP
Author and Funding Information

From the Center for Translational Lung Biology, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

CORRESPONDENCE TO: Nuala J. Meyer, MD, FCCP, Center for Translational Lung Biology, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania Perelman School of Medicine, 3600 Spruce St, 5039 Gates Bldg, Philadelphia, PA 19104; e-mail: nuala.meyer@uphs.upenn.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(4):1073-1082. doi:10.1378/chest.15-0076
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A central tenet of caring for patients with ARDS is to treat the underlying cause, be it sepsis, pneumonia, or removal of an offending toxin. Identifying the risk factor for ARDS has even been proposed as essential to diagnosing ARDS. Not infrequently, however, the precipitant for acute hypoxemic respiratory failure is unclear, and this raises the question of whether a histologic lung diagnosis would benefit the patient. In this review, we consider the historic role of pathology in establishing a diagnosis of ARDS and the published experience of surgical and transbronchial lung biopsy in patients with ARDS. We reflect on which pathologic diagnoses influence treatment and suggest a patient-centric approach to weigh the risks and benefits of a lung biopsy for critically ill patients who may have ARDS.

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