Combined autologous blood patch-immediate patient rollover does not reduce the pneumothorax or chest drain rate following CT-guided lung biopsy compared to immediate patient rollover alone.

Autor: Duignan JA; Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland. Electronic address: jonniedodd@gmail.com., Ryan DT; Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland., O'Riordan B; Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Ireland., O'Brien A; Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland., Healy GM; Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland., O'Brien C; Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland., Butler M; Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Ireland., Keane MP; Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Ireland., McCarthy C; Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Ireland., Murphy DJ; Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Ireland., Dodd JD; Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Ireland. Electronic address: jonniedodd@gmail.com.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2023 Mar; Vol. 160, pp. 110691. Date of Electronic Publication: 2023 Jan 09.
DOI: 10.1016/j.ejrad.2023.110691
Abstrakt: Puprose: The purpose of this study was to evaluate a combined autologous blood-patch (ABP)-immediate patient rollover (IPR) technique compared with the IPR technique alone on the incidence of pneumothorax and chest drainage following CT-guided lung biopsy.
Methods: In this interventional cohort study of both prospectively and retrospectively acquired data, 652 patients underwent CT-guided lung biopsy. Patient demographics, lesion characteristics and technical biopsy variables including the combined ABP-IPR versus IPR alone were evaluated as predictors of pneumothorax and chest drain rates using regression analysis.
Results: The combined ABP-IPR technique was performed in 259 (39.7 %) patients whilst 393 (60.3 %) underwent IPR alone. There was no significant difference in pneumothorax rate or chest drains required between the combined ABP-IPR vs IPR groups (p =.08, p =.60 respectively). Predictors of pneumothorax adjusted for the combined ABP-IPR and IPR alone groups included age (p =.02), lesion size (p =.01), location (p =.005), patient position (p =.008), emphysema along the needle track (p =.005) and lesion distance from the pleura (p =.02). Adjusted predictors of chest drain insertion included lesion location (p =.09), patient position (p =.002), bullae crossed (p =.02) and lesion distance from the pleura (p =.02).
Conclusion: The combined ABP-IPR technique does not reduce the pneumothorax or chest drain rate compared to the IPR technique alone. Utilising IPR without an ABP following CT-guided lung biopsy results in similar pneumothorax and chest drain rates while minimising the potential risk of systemic air embolism.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: