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• W4323036867 abstract "Rationale: Transbronchial lung biopsies (TBLB) are commonly performed by pulmonologists. Most providers consider pulmonary hypertension (PH) to be at least a relative contraindication to TBLB. This practice is primarily based on expert opinion as there is very little patient outcomes data backing it. Objectives: We performed a systematic review and meta-analysis of the previously published studies to determine the safety of TBLB in patients with PH. Methods: MEDLINE, Embase, Scopus, and Google Scholar databases were searched for pertinent studies. The quality of the included studies was assessed using the New Castle-Ottawa Scale (NOS). Meta-analysis was performed using MedCalc version 20.118 to calculate the weighted pooled relative risk of complications in patients with PH. Results: 9 studies with a total of 1699 patients were included in the meta-analysis. Based on NOS the risk of bias was low in the included studies. The overall weighted relative risk of bleeding with TBLB in PH patients was 1.01 (95% CI, 0.71-1.45), compared to patients without PH. Heterogeneity was low; therefore, the fixed effects model was used. In a sub-group analysis of 3 studies, the overall weighted relative risk of significant hypoxia in patients with PH was 2.06 (95% CI 1.12 - 3.76). Conclusion: Our results show that the patients with PH do not have a significantly elevated risk of bleeding with TBLB as compared to the controls. We hypothesize that significant post-biopsy bleeding might be preferentially originating from bronchial artery circulation as opposed to pulmonary artery circulation, much like episodes of massive spontaneous hemoptysis. This hypothesis can explain our results as in this scenario, elevated pulmonary artery pressure wouldn’t be expected to have a bearing on the risk of post-TBLB bleeding. Most of the studies in our analysis included patients with mild to moderate PH and it's not clear if our results can be extrapolated to patients with severe PH. We noted that the patients with PH were at a higher risk of developing hypoxia and needing a longer duration of mechanical ventilation with TBLB, as compared to the controls. Further studies are needed to better understand the origin and pathophysiology of post-TBLB bleeding." @default.
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• W4323036867 date "2023-06-01" @default.
• W4323036867 modified "2023-09-26" @default.
• W4323036867 title "Safety of Transbronchial Biopsies in Patients with Pulmonary Hypertension: Systematic Review and Meta-Analysis" @default.
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• W4323036867 doi "https://doi.org/10.1513/annalsats.202211-965oc" @default.
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