The Role of Open Lung Biopsy in Critically Ill Patients with Hypoxic Respiratory Failure: A Retrospective Cohort Study
Background. The aim of this study was to assess the utility of open lung biopsy in patients with hypoxic respiratory failure of unknown etiology admitted to an ICU and to examine the use of steroid therapy in this patient population. Methods. A retrospective cohort study was performed of all consecu...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2016/8715024 |
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| author | Abdullah Almotairi Sharmistha Biswas Jason Shahin |
| author_facet | Abdullah Almotairi Sharmistha Biswas Jason Shahin |
| author_sort | Abdullah Almotairi |
| collection | DOAJ |
| description | Background. The aim of this study was to assess the utility of open lung biopsy in patients with hypoxic respiratory failure of unknown etiology admitted to an ICU and to examine the use of steroid therapy in this patient population. Methods. A retrospective cohort study was performed of all consecutive patients admitted to three tertiary care, university-affiliated, ICUs during the period from January 2000 to January 2012 with the principal diagnosis of hypoxic respiratory failure and who underwent an open lung biopsy. Results. Open lung biopsy resulted in a diagnostic yield of 68% and in a 67% change of management in patients. A multivariable analysis of clinical variables associated with acute hospital mortality demonstrated that postbiopsy systemic steroid therapy (OR 0.24, 95% C.I 0.06–0.96) was significantly associated with improved survival. Complications arising from the biopsy occurred in 30% of patients. Conclusion. Open lung biopsy had significant diagnostic yield and led to major changes in management and aided in end-of-life decision-making in the ICU. Systemic steroid therapy was associated with improved survival. The risk-benefit ratio of open lung biopsy is still unclear, especially given the availability of newer diagnostic tests and possible empirical therapy with steroids. |
| format | Article |
| id | doaj-art-b923f49fa4804974adbc733221eede3d |
| institution | Kabale University |
| issn | 1198-2241 1916-7245 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-b923f49fa4804974adbc733221eede3d2025-02-03T05:47:55ZengWileyCanadian Respiratory Journal1198-22411916-72452016-01-01201610.1155/2016/87150248715024The Role of Open Lung Biopsy in Critically Ill Patients with Hypoxic Respiratory Failure: A Retrospective Cohort StudyAbdullah Almotairi0Sharmistha Biswas1Jason Shahin2McGill University, 845 Sherbrooke Street West, Montreal, QC, H3A 2T5, CanadaDepartment of Critical Care and Department of Medicine, Respiratory Division, Respiratory Epidemiology Clinical Research Unit, McGill University Health Centre, 687 Pine Avenue West, Montreal, QC, H3A 1A1, CanadaMcGill University, 845 Sherbrooke Street West, Montreal, QC, H3A 2T5, CanadaBackground. The aim of this study was to assess the utility of open lung biopsy in patients with hypoxic respiratory failure of unknown etiology admitted to an ICU and to examine the use of steroid therapy in this patient population. Methods. A retrospective cohort study was performed of all consecutive patients admitted to three tertiary care, university-affiliated, ICUs during the period from January 2000 to January 2012 with the principal diagnosis of hypoxic respiratory failure and who underwent an open lung biopsy. Results. Open lung biopsy resulted in a diagnostic yield of 68% and in a 67% change of management in patients. A multivariable analysis of clinical variables associated with acute hospital mortality demonstrated that postbiopsy systemic steroid therapy (OR 0.24, 95% C.I 0.06–0.96) was significantly associated with improved survival. Complications arising from the biopsy occurred in 30% of patients. Conclusion. Open lung biopsy had significant diagnostic yield and led to major changes in management and aided in end-of-life decision-making in the ICU. Systemic steroid therapy was associated with improved survival. The risk-benefit ratio of open lung biopsy is still unclear, especially given the availability of newer diagnostic tests and possible empirical therapy with steroids.http://dx.doi.org/10.1155/2016/8715024 |
| spellingShingle | Abdullah Almotairi Sharmistha Biswas Jason Shahin The Role of Open Lung Biopsy in Critically Ill Patients with Hypoxic Respiratory Failure: A Retrospective Cohort Study Canadian Respiratory Journal |
| title | The Role of Open Lung Biopsy in Critically Ill Patients with Hypoxic Respiratory Failure: A Retrospective Cohort Study |
| title_full | The Role of Open Lung Biopsy in Critically Ill Patients with Hypoxic Respiratory Failure: A Retrospective Cohort Study |
| title_fullStr | The Role of Open Lung Biopsy in Critically Ill Patients with Hypoxic Respiratory Failure: A Retrospective Cohort Study |
| title_full_unstemmed | The Role of Open Lung Biopsy in Critically Ill Patients with Hypoxic Respiratory Failure: A Retrospective Cohort Study |
| title_short | The Role of Open Lung Biopsy in Critically Ill Patients with Hypoxic Respiratory Failure: A Retrospective Cohort Study |
| title_sort | role of open lung biopsy in critically ill patients with hypoxic respiratory failure a retrospective cohort study |
| url | http://dx.doi.org/10.1155/2016/8715024 |
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