CHEST Guidelines-Risk-Factors-of-Infectious-Complications-After-End

Risk-Factors-of-Infectious-Complications-After-End

Pdf Summary

The study explores the risk factors associated with infectious complications following endobronchial ultrasound-guided transbronchial biopsy with a guide sheath (EBUS-GS-TBB). Conducted at Fujita Health University Hospital, the study retrospectively examined 1,045 patients who underwent EBUS-GS-TBB between 2013 and 2017. Out of these, 47 patients developed infectious complications, which sometimes delayed or canceled subsequent cancer treatments, and resulted in three deaths.<br /><br />Key findings from multivariate analysis indicated that cavitation, low-density areas (LDAs) within the lesion as seen on CT scans, and bronchial stenosis identified during bronchoscopy were significantly associated with the development of infectious complications post-EBUS-GS-TBB. The study highlights that these complications, which include pneumonia, lung abscesses, pleuritis, and others, are primarily driven by an inﬂammation-prone status in the lesions, indicating that the introduction of microorganisms or manipulation during the procedure might exacerbate local inﬂammation.<br /><br />Additionally, the study evaluated the efficacy of prophylactic antibiotics in preventing these infections. Although prophylactic antibiotics were administered to some patients, propensity score matching analysis showed no significant benefit in preventing post-procedural infections, aligning with existing guidelines that do not support routine antibiotic prophylaxis for this procedure.<br /><br />The study stresses the necessity of identifying patients at higher risk for these complications, particularly those with factors suggesting lesion necrosis and drainage pathway obstruction, to potentially modify biopsy strategies and follow-up care. While unable to provide a definitive preventative approach, the research identifies critical risk factors and prompts further studies to establish effective management and prophylactic strategies against infections after EBUS-GS-TBB.

Keywords

infectious complications

endobronchial ultrasound

transbronchial biopsy

risk factors

cavitation

bronchial stenosis

prophylactic antibiotics

Fujita Health University

lung abscesses

biopsy strategies