title: Open lung biopsy in the critically ill newborn.
abstract: Experience with 17 open lung biopsies in critically ill premature neonates was reviewed. Despite their small size, prematurity, and near maximal ventilator requirements, the infants suffered no significant complications. In three cases, an infectious agent was identified. In one case end-stage lung fibrosis associated with persistent (greater than 3 months), severe respiratory failure prompted termination of support. In the remainder of the cases, definitively ruling out infection allowed the confident trial of a course of steroids in an attempt to treat bronchopulmonary dysplasia. Unlike older patients, the definitive diagnosis of no infection in the premature neonate is just as informative as the diagnosis of an infection. Used judiciously, open lung biopsy can be performed in the premature infant with acceptable morbidity and mortality.
authors.affiliation: Section of Pediatric Surgery, Wilford Hall USAF Medical Center, Lackland AFB, TX 78236.
authors.forename: H W
authors.initials: HW
authors.lastname: Cheu
authors.forename: K P
authors.initials: KP
authors.lastname: Lally
authors.forename: R
authors.initials: R
authors.lastname: Clark
authors.forename: S
authors.initials: S
authors.lastname: Harrell
authors.forename: D
authors.initials: D
authors.lastname: Null
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy / Q000379:methods*; D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008168:Lung / Q000473:pathology*; D009175:Mycoplasma Infections / Q000188:drug therapy; D011379:Prognosis; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D013256:Steroids / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D013256:Steroids