R. Steinberg et al., OPEN LUNG-BIOPSY - SUCCESSFUL DIAGNOSTIC-TOOL WITH THERAPEUTIC IMPLICATION IN THE CRITICALLY ILL PEDIATRIC POPULATION, Acta paediatrica, 87(9), 1998, pp. 945-948
Open lung biopsy (OLB) is an important diagnostic tool in children wit
h immune deficiency and/or chronic lung disease with diffuse pulmonary
compromise. These patients require a tailored therapeutic approach ow
ing to their fragile status and the side effects of unnecessary or ina
dequate 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 othe
r lung diseases. The biopsies were diagnostic in 25 patients (96%), an
d 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 p
ostoperative complications (prolonged pleural leak). We conclude that
OLB is a safe diagnostic procedure even in the critically ill child an
d should be employed without hesitation when conventional methods fail
to provide a definitive diagnosis to help redirect therapy.