Patient positioning after lung biopsy: influence on the incidence of pneumothorax

To determine if post-biopsy complication rates were influenced by patient positioning after the procedure.

A prospective evaluation of post-biopsy complications in 87 patients (55 men, 32 women; mean age 66 yr, range 20-86 yr) undergoing fine-needle aspiration biopsy of lung nodules was performed. Biopsies were performed under computed tomographic guidance in 66 patients, fluoroscopic guidance in 18 and ultrasonographic guidance in 3 patients. Patients were randomly assigned to be placed either in the lateral decubitus "biopsy-side-down" position or in the "biopsy-site-dependent" position (i.e., lying directly on the skin puncture site) after surgery. Chest imaging was performed immediately and at 4 hours after biopsy.

Immediately after the procedure, 6 (14%) of the 42 patients in the decubitus biopsy-side-down group and 15 (33%) of the 45 patients in the site-dependent group experienced pneumothoraces (p > 0.05). No patient required tube thoracostomy. Two patients in the decubitus group and 1 in the site-dependent group experienced hemoptysis immediately after biopsy. On the 4-hour chest radiographs, there was no progression in size of the existing pneumothoraces.

Positioning the patient either decubitus biopsy-side-down or lying directly on the puncture site after lung biopsy does not appear to affect complication rates.