Complications of a lung biopsy for severe respiratory failure: A systematic review and meta-analysis.

Abstract

BackgroundThis systematic review and meta-analysis aimed to evaluate the complications of lung biopsy in patients with acute respiratory failure (ARF), including acute respiratory distress syndrome (ARDS).MethodsWe searched the MEDLINE and Cochrane Central Register of Controlled Trials. The primary outcomes were biopsy-related death, respiratory failure, cardiac complications, bleeding, and other major complications. We used the McMaster Quality Assessment Scale of Harms (McHarm) to evaluate the risk of bias. A random-effects model was used to calculate the pooled frequencies.ResultsThirteen studies (consisting of 574 patients) were included in the meta-analysis. Furthermore, most of the included studies had a high or unclear risk of bias in half of the items in McHarm. All included studies evaluated surgical lung biopsies. The median overall hospital mortality was 53% (range: 17%–90%). The pooled frequencies of biopsy-related death, respiratory failure, cardiac complication, bleeding, and other major complications were 0.00% (95% confidence interval [CI]: 0.00%–0.21%), 1.30% (95% CI: 0.00%–5.69%), 1.03% (95% CI: 0.00%–3.73%), 1.46% (95% CI: 0.16%–3.56%), and 4.26% (95% CI: 0.00%–13.0%), respectively.ConclusionsThe results of this study will be valuable information in considering the indications of lung biopsy in patients with ARF, including ARDS.Trial registrationThe protocol was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN 000040650).