Open lung biopsy: successful diagnostic tool with therapeutic implication in the critically ill paediatric population

• Published in: Acta pædiatrica (Oslo) Vol. 87; no. 9; pp. 945 - 948
• Main Authors: STEINBERG, R, FREUD, E, BEN-ARI, J, SCHONFELD, T, GOLINSKY, D, MOR, C, ZER, M
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell 01.09.1998
• Subjects: Adolescent; Biological and medical sciences; Biopsy - methods; Child; Child, Preschool; Critical Illness; Female; Humans; Immunocompromised Host; Infant; Investigative techniques, diagnostic techniques (general aspects); Lung - pathology; Male; Medical sciences; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Predictive Value of Tests; Respiratory system; Human; Biopsy; Indication; Surgery; Lung; Diagnosis; Safety; Child; Result
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1080/080352598750031590

Open lung biopsy (OLB) is an important diagnostic tool in children with immune deficiency and/or chronic lung disease with diffuse pulmonary compromise. These patients require a tailored therapeutic approach owing to their fragile status and the side effects of unnecessary or inadequate treatment. Twenty-six patients of mean age 5.6 y underwent 41 open lung biopsies in our centre between 1991 and 1995. Seventeen (65%) were immunocompromised (including 13 with malignancy) and 9 had other lung diseases. The biopsies were diagnostic in 25 patients (96%), and complete clinical-pathological correlation was found in 11 (42%). A specific infectious aetiology was detected in nine patients (35%), all of them immunocompromised. Therapeutic changes were instituted on the basis of the biopsy findings in 18 patients (69%). Two patients had postoperative complications (prolonged pleural leak). We conclude that OLB is a safe diagnostic procedure even in the critically ill child and should be employed without hesitation when conventional methods fail to provide a definitive diagnosis to help redirect therapy.