Nonclotted Blood Patch Technique Reduces Pneumothorax and Chest Tube Placement Rates After Percutaneous Lung Biopsies.
OBJECTIVE
The aim of this study was to determine whether autologous nonclotted blood patch decreases pneumothorax and chest tube placement rates in computed tomography-guided biopsies of the lung.


METHODS
Percutaneous computed tomography-guided lung biopsies performed over a period of 6 years were retrospectively reviewed to determine the overall rates of pneumothorax and chest tube placement and rates before and after the autologous nonclotted blood patch procedure was instituted as a departmental policy. The effect of the intervention was only assessed in patients in whom a blood patch could be applied, therefore only when the needle traversed an aerated lung and only when the needle remained in the lung at the end of the study.


RESULTS
There was a statistically significant decrease in both the rate of pneumothorax [28% (69/245) vs. 42% (80/189); P=0.002] and chest tube placement [4% (10/245) vs. 16% (30/189); P<0.001] in patients who received nonclotted blood patch versus those who did not. Blood patch was performed in 222/312 (71%) eligible patients after the introduction of the blood patch policy. After policy introduction, there was a decreased rate of pneumothorax, with a rate of 32% (101/312) versus 40% (49/122) (P=0.12) and a statistically significant decrease in departmental chest tube placement rates of 6% (20/312) versus 16% (20/122) (P=0.001).


CONCLUSIONS
Nonclotted autologous blood patch for percutaneous lung biopsy resulted in significantly decreased pneumothorax and chest tube placement rates in our patient population.
*Department of Radiology, San Francisco General Hospital †Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA.
Joshua D
JD
Clayton
Brett M
BM
Elicker
Karen G
KG
Ordovas
Maureen P
MP
Kohi
Janet
J
Nguyen
David M
DM
Naeger
D000368:Aged; D001707:Biopsy, Needle; D017217:Blood Patch, Epidural / Q000379:methods*; D015505:Chest Tubes / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D011030:Pneumothorax / Q000517:prevention & control*; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome