title: Ambulatory percutaneous lung biopsy with early discharge and Heimlich valve management of iatrogenic pneumothorax: more for less.
abstract: A prospective study of 489 consecutive outpatient image-guided percutaneous lung biopsies was conducted to determine whether early discharge, incorporating ambulatory Heimlich valve drain, is potentially advantageous to the National Health Service. Patients were discharged at 30 or 60 min, with significant pneumothoraces treated using Heimlich valve. 485 (99.2%) patients were successfully discharged early, 402 at 30 min. 87 (17.8%) patients developed pneumothorax: 52 required Heimlich valve; 5 proceeded to biopsy with Heimlich valve in situ. All drains were removed within 48 h, 38/52 (73.1%) at 24 h. Our results provide evidence for a paradigm shift in UK practice: early discharge lung biopsy, facilitated by ambulatory Heimlich valve, is safe with significant clinical and economic benefits.
authors.affiliation: Department of Radiology, Barnet General Hospital, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: A N
authors.initials: AN
authors.lastname: Tavare
authors.affiliation: Department of Respiratory Medicine, Barnet General Hospital, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: D D
authors.initials: DD
authors.lastname: Creer
authors.affiliation: Department of Respiratory Medicine, Barnet General Hospital, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Khan
authors.affiliation: Department of Respiratory Medicine, Barnet General Hospital, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Vancheeswaran
authors.affiliation: Department of Radiology, Barnet General Hospital, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: S S
authors.initials: SS
authors.lastname: Hare
mesh_terms: D000368:Aged; D019468:Disease Management; D004322:Drainage / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D061705:Image-Guided Biopsy / Q000009:adverse effects*; D008168:Lung / Q000473:pathology*; D008171:Lung Diseases / Q000175:diagnosis*; D008297:Male; D010045:Outpatients; D010351:Patient Discharge; D011030:Pneumothorax / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies
keywords: Lung Cancer