Prevention of pneumothorax in needle lung biopsy by breathing 100% oxygen

Abstract

To decrease pneumothorax after transthoracic needle lung biopsy, the effect of breathing 100% O2 during the procedure was evaluated. Consecutive biopsies [50] on 46 hospital patients were performed on subjects breathing O2 or compressed air. The selected gas, chosen randomly, was given for 5 min before the biopsy and continued for 30 min after. Procedures [26] were on air (group 1) and 24 on pure O2 (group 2). Four subjects in group 2 were eliminated from analysis because they were unable to sustain the required O2 breathing. Results showed fewer pneumothoraces with subjects breathing O2 (4 of 20) than with those breathing air (11 of 26). Three patients in group 1 required chest tube drainage for symptoms of dyspnea, but none were required in group 2. The peak area of gas accumulation for each pneumothorax was smaller in group 2, with a mean surface area of 27.1 cm2 (range 9.6-63.8), than in group 1 mean of 68.1 cm2 (range 6.4-172.4). Fewer pneumothoraces in the O2 group may be explained by rapid absorption of small leaks immediately after lung puncture. These results were statistically significant (P < 0.05). 100% O2 breathing during transthoracic needle biopsy decreases the number and size of pneumothoraces. This simple technique should decrease the morbidity of transthoracic needle lung biopsy.