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Multicenter Study
. 2017 Oct;195(5):537-543.
doi: 10.1007/s00408-017-0028-z. Epub 2017 Jun 16.

Pneumothorax After Transbronchial Biopsy in Pulmonary Fibrosis: Lessons from the Multicenter COMET Trial

Jonathan A Galli  1 , Nicholas L Panetta  2 , Nathaniel Gaeckle  2 , Fernando J Martinez  3 , Bethany Moore  3 , Thomas Moore  3 , Anthony Courey  3 , Kevin Flaherty  3 , Gerard J Criner  2 ; COMET investigators
Affiliations
Multicenter Study

Pneumothorax After Transbronchial Biopsy in Pulmonary Fibrosis: Lessons from the Multicenter COMET Trial

Jonathan A Galli et al. Lung. 2017 Oct.

Abstract

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.

Trial registration: ClinicalTrials.gov NCT01071707.

Keywords: Idiopathic pulmonary fibrosis; Pneumothorax; Risk factors; Transbronchial biopsy.

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Conflict of interest statement

Conflict of Interest:

The authors have no financial or non-financial conflicts of interest to disclose.

Figures

Figure 1
Figure 1. Follow-up pulmonary function testing in subjects with iatrogenic pneumothorax following transbronchial biopsies
No significant difference was observed in FEV1, FVC, or DLCO on follow-up pulmonary function testing in pulmonary fibrosis subjects who developed pneumothorax following research bronchoscopy.
See this image and copyright information in PMC

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