title: CT-guided lung biopsies: pleural blood patching reduces the rate of chest tube placement for postbiopsy pneumothorax.
abstract: OBJECTIVE
  The objective of our study was to determine whether pleural blood patching reduces the need for chest tube placement and hospital admission for pneumothorax complicating CT-guided percutaneous lung biopsy.
  
  
  METHODS
  We reviewed 463 CT-guided lung biopsies performed between August 2006 and March 2010 to determine whether intervention for pneumothorax was required and patient outcome. Intervention was categorized as simple aspiration, aspiration and intrapleural blood patching, or chest tube placement and hospital admission. The technique for pleural blood patching consisted of complete pneumothorax aspiration, immediate placement of up to 15 mL of peripheral autologous blood into the pleural space, and positioning the patient in the ipsilateral decubitus position for 1 hour after the procedure.
  
  
  RESULTS
  Intervention for pneumothorax was necessary in 45 of 463 patients (9.7%) and 19 of 463 patients (4.1%) required chest tube placement. Pleural blood patching as a method to treat a postbiopsy pneumothorax and avoid further intervention was associated with a significantly higher success rate than simple aspiration: 19 of 22 (86.4%) vs seven of 15 (46.7%) (odds ratio = 7.2, p = 0.03), respectively.
  
  
  CONCLUSIONS
  Aspiration with intrapleural blood patching is superior to simple aspiration to treat pneumothorax associated with CT-guided lung biopsy. Pleural blood patching reduces the need for chest tube placement and hospital admission in this patient population.
authors.affiliation: Department of Radiology, University of Wisconsin, 600 Highland Ave, Mail Code 3252, E3/311 CSC, Madison, WI 53792-3252, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Wagner
authors.forename: J Louis
authors.initials: JL
authors.lastname: Hinshaw
authors.forename: Meghan G
authors.initials: MG
authors.lastname: Lubner
authors.forename: Jessica B
authors.initials: JB
authors.lastname: Robbins
authors.forename: David H
authors.initials: DH
authors.lastname: Kim
authors.forename: Perry J
authors.initials: PJ
authors.lastname: Pickhardt
authors.forename: Fred T
authors.initials: FT
authors.lastname: Lee
mesh_terms: D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D001804:Blood Transfusion, Autologous / Q000379:methods*; D015505:Chest Tubes; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D008297:Male; D018700:Pleurodesis / Q000379:methods*; D011030:Pneumothorax / Q000209:etiology / Q000517:prevention & control*; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome