Pulmonary Hypertension and Transbronchial Lung Biopsy: Does It Increase the Risk of Hemorrhage?

Abstract

Background Bronchoscopy with transbronchial lung biopsy (TBLB) is commonly used as a diagnostic tool for pulmonary disease. Hemorrhage is a major complication of TBLB. While pulmonary hypertension (PH) is considered a risk factor, evidence supporting this is limited. In this study, we compare complications of TBLB in patients with PH to those without PH. Material and methods We performed a retrospective review of patients who underwent TBLB in our institution from January 2010 to May 2016. PH and non-PH groups were compared with respect to patient demographics, biopsy guidance, number of lobes biopsied (single or multiple), positive pressure ventilation, pre- and post-procedure diagnoses, and complications. Complications were defined as major hemorrhage, prolonged intubation, and reintubation within 72 hours from TBLB. Results The PH group had 45 patients with a mean age of 71 +/- 14 years, and the non-PH group had 349 patients with a mean age of 63 +/- 14 years. There were no significant differences with regards to gender, pre-procedure anticoagulation and antiplatelet agents, biopsy guidance, or number of lobes biopsied (p > 0.371). There was no significant difference in the occurrence of major hemorrhage between the two groups (p = 0.491). Prolonged intubation occurred more frequently in the PH group (p = 0.007). Conclusions There appears to be no increased risk of post-procedure hemorrhage with TBLB in patients with mild PH. There is, however, an increased risk of post-procedure prolonged intubation in these patients.