{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T07:07:00Z","timestamp":1760080020799},"reference-count":11,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,11,3]],"date-time":"2016-11-03T00:00:00Z","timestamp":1478131200000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>There are conflicting reports regarding the role of surgical lung biopsies in patients who present to the intensive care unit (<jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>) with unexplained respiratory failure and diffuse pulmonary infiltrates on imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To describe the utility of surgical lung biopsies in patients presenting to the <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> with unexplained respiratory failure and diffuse pulmonary infiltrates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was performed. All patients admitted to the <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> who underwent a surgical lung biopsy for the investigation of respiratory failure and unexplained pulmonary infiltrates between 1998 and 2012 were included. The primary outcome measures for this descriptive study were the biopsy histopathology, changes in patient management following biopsy and in\u2010hospital mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 30 patients was included in the review. Biopsies in 22 patients (73%) demonstrated diffuse alveolar damage (<jats:styled-content style=\"fixed-case\">DAD<\/jats:styled-content>), with 15 of these biopsies (50%) suggesting a specific underlying aetiology. In 73% of cases (<jats:italic>n<\/jats:italic>\u2009=\u200922), the biopsy finding was associated with a change in management, although this generally involved the escalation of an existing therapy rather than initiation of a new treatment. Biopsies were performed at a median 10\u2009days after admission (interquartile range 5\u201317\u2009days), with the majority of patients being treated empirically prior to the biopsy with systemic steroids and broad\u2010spectrum antimicrobials. Mortality was 53%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this series, <jats:styled-content style=\"fixed-case\">DAD<\/jats:styled-content> was the most frequent pathology. The biopsy result was associated with a change in management in a majority of the subjects, most frequently an escalation of prior empiric therapy. Mortality was high.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13222","type":"journal-article","created":{"date-parts":[[2016,8,17]],"date-time":"2016-08-17T07:57:06Z","timestamp":1471420626000},"page":"1306-1310","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Utility of surgical lung biopsy in critically ill patients with diffuse pulmonary infiltrates: a retrospective review"],"prefix":"10.1111","volume":"46","author":[{"given":"L. H.","family":"Donaldson","sequence":"first","affiliation":[{"name":"Malcolm Fisher Department of Intensive Care Medicine Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. J.","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Surgical Pathology University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Anatomical Pathology Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Hibbert","sequence":"additional","affiliation":[{"name":"Northern Clinical School, Sydney Medical School University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Respiratory Medicine Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,11,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.5.1602"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0291"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.115.3.811"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.125.1.197"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000257325.88144.30"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)60096-3"},{"key":"e_1_2_6_8_1","first-page":"316","article-title":"Benefit of open lung biopsy in patients with respiratory failure","volume":"38","author":"Lachapelle KJ","year":"1995","journal-title":"Can J Surg"},{"key":"e_1_2_6_9_1","first-page":"CR365","article-title":"Risks and benefits of open\u2010lung biopsy in the mechanically ventilated critically ill population: a cohort study and literature review","volume":"13","author":"Arabi Y","year":"2007","journal-title":"Med Sci Monit"},{"key":"e_1_2_6_10_1","first-page":"117","article-title":"Role of open lung biopsy in patients with diffuse lung infiltrates and acute respiratory failure","volume":"104","author":"Soh L\u2010H","year":"2005","journal-title":"J Formos Med Assoc"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.05.029"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc6106"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.13222","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.13222","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.13222","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T14:15:28Z","timestamp":1696169728000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.13222"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11]]},"references-count":11,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2016,11]]}},"alternative-id":["10.1111\/imj.13222"],"URL":"https:\/\/doi.org\/10.1111\/imj.13222","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11]]},"assertion":[{"value":"2016-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-08-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-11-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}