The value of emergency open lung biopsy in infants and children

Abstract

The records of 36 infants and children who underwent emergency open lung biopsy at the Hospital for Sick Children, Toronto, between 1969 and 1976 were studied in order to assess the safety and value of performing this procedure in patients with failing respiratory function. Prior to their respiratory illness, 14 of these patients were receiving steroids, chemotherapy, and radiotherapy singly or in combination as treatment for various sytemic diseases of which leukemia was the most prominent. In all cases the biopsy was performed under general anesthesia and lasted about 1 hour. The biopsy was diagnostic in all but one of these children, permitting the institution of appropriate therapy. Six preventible postoperative complications required treatment but there were no deaths attributable to operation in this series. Emergency open lung biopsy is strongly recommended even in patients in severe respiratory failure when all routine investigations fail to yield a diagnosis.