TY - JOUR
T1 - Pneumothorax After Transbronchial Biopsy in Pulmonary Fibrosis
T2 - Lessons from the Multicenter COMET Trial
AU - for the COMET investigators
AU - Galli, Jonathan A.
AU - Panetta, Nicholas L.
AU - Martinez, Fernando J.
AU - Gaeckle, Nathaniel T
AU - Moore, Thomas
AU - Courey, Anthony
AU - Flaherty, Kevin
AU - Criner, Gerard J.
N1 - Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Purpose: Some patients with diffuse interstitial lung disease (ILD) undergo bronchoscopy with transbronchial biopsy (TBB) as part of their diagnostic evaluation. It is unclear what the incidence and risk factors for pneumothorax (PTX) following TBB are in this patient population. Methods: Ninety-seven subjects with pulmonary fibrosis who underwent a research bronchoscopy with TBB as part of the multicenter correlating outcomes with biochemical markers to estimate time-progression in idiopathic pulmonary fibrosis (COMET) trial were retrospectively reviewed. We compared subjects who developed a PTX during research bronchoscopy with TBB versus those who did not. Results: Seven patients (7.2%) experienced a PTX during research bronchoscopy with TBB. Subjects who experienced PTX during TBB had significantly lower DLCO percent predicted (29 ± 8 vs. 45 ± 15, P = 0.006) and had lower resting room air saturation of peripheral oxygen (SPO2) on 6-min walk testing (91 ± 10 vs. 95 ± 3, P = 0.02). No differences between groups were found with respect to age, gender, race, BMI, HRCT characteristics, or the number of transbronchial biopsies performed. Conclusion: The incidence of PTX following research bronchoscopy with TBB in patients with pulmonary fibrosis was found to be 7.2% in this study. Patients who developed a pneumothorax had greater impairments in gas exchange at baseline evidenced by a lower DLCO % predicted and a lower resting room air SPO2 compared with subjects without PTX as a complication.
AB - Purpose: Some patients with diffuse interstitial lung disease (ILD) undergo bronchoscopy with transbronchial biopsy (TBB) as part of their diagnostic evaluation. It is unclear what the incidence and risk factors for pneumothorax (PTX) following TBB are in this patient population. Methods: Ninety-seven subjects with pulmonary fibrosis who underwent a research bronchoscopy with TBB as part of the multicenter correlating outcomes with biochemical markers to estimate time-progression in idiopathic pulmonary fibrosis (COMET) trial were retrospectively reviewed. We compared subjects who developed a PTX during research bronchoscopy with TBB versus those who did not. Results: Seven patients (7.2%) experienced a PTX during research bronchoscopy with TBB. Subjects who experienced PTX during TBB had significantly lower DLCO percent predicted (29 ± 8 vs. 45 ± 15, P = 0.006) and had lower resting room air saturation of peripheral oxygen (SPO2) on 6-min walk testing (91 ± 10 vs. 95 ± 3, P = 0.02). No differences between groups were found with respect to age, gender, race, BMI, HRCT characteristics, or the number of transbronchial biopsies performed. Conclusion: The incidence of PTX following research bronchoscopy with TBB in patients with pulmonary fibrosis was found to be 7.2% in this study. Patients who developed a pneumothorax had greater impairments in gas exchange at baseline evidenced by a lower DLCO % predicted and a lower resting room air SPO2 compared with subjects without PTX as a complication.
KW - Idiopathic pulmonary fibrosis
KW - Pneumothorax
KW - Risk factors
KW - Transbronchial biopsy
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U2 - 10.1007/s00408-017-0028-z
DO - 10.1007/s00408-017-0028-z
M3 - Article
C2 - 28623539
AN - SCOPUS:85020511127
SN - 0341-2040
VL - 195
SP - 537
EP - 543
JO - Lung
JF - Lung
IS - 5
ER -
