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Complications of a lung biopsy for severe respiratory failure: A systematic review and meta-analysis

Hiroshi Sugimoto1, Yosuke Fukuda2, Yoshie Yamada3

  • 1Department of Respiratory Medicine, Kobe Red Cross Hospital, Hyogo, Japan.

Respiratory Investigation
|September 26, 2022
PubMed
Abstract

Insights

Lung biopsy in acute respiratory failure (ARF) patients, including acute respiratory distress syndrome (ARDS), shows low rates of biopsy-related death and major complications. These findings aid in considering biopsy indications for ARF patients.

Area of Science:

  • Pulmonary Medicine
  • Critical Care Medicine
  • Interventional Pulmonology

Background:

  • Assesses complications of lung biopsy in patients with acute respiratory failure (ARF), including acute respiratory distress syndrome (ARDS).
  • Highlights the need for evidence-based guidance on lung biopsy indications in critically ill patients.

Approach:

  • Systematic review and meta-analysis of 13 studies involving 574 patients.
  • Searched MEDLINE and Cochrane Central Register of Controlled Trials for relevant studies.
  • Evaluated risk of bias using the McMaster Quality Assessment Scale of Harms (McHarm).

Key Points:

  • Pooled frequency of biopsy-related death was 0.00% (95% CI: 0.00%-0.21%).
  • Pooled frequencies for respiratory failure, cardiac complications, and bleeding were 1.30%, 1.03%, and 1.46%, respectively.
  • Most studies had a high or unclear risk of bias, indicating a need for higher quality research.

Conclusions:

  • Lung biopsy in ARF/ARDS patients has a low incidence of direct biopsy-related mortality and major complications.
  • Findings provide valuable data for clinical decision-making regarding the indications for lung biopsy in ARF patients.
  • Future research should focus on improving the quality of studies evaluating lung biopsy complications.
Keywords:
Acute respiratory distress syndrome (ARDS)Acute respiratory failureComplicationsLung biopsy

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