Skupin A, Gomez F, Husain M, Skupin C, Bigman O
Ann Thorac Surg. 1987 Apr;43(4):406-8. doi: 10.1016/s0003-4975(10)62816-0.
To explore the possibility of performing percutaneous lung biopsy safely in patients mechanically ventilated with positive-end expiratory pressure (PEEP), transthoracic needle biopsy was performed in 16 anesthetized mongrel dogs mechanically ventilated with 10 cm H2O of PEEP. To obtain the biopsy sample, a 25-gauge "skinny needle" was passed through a 20-gauge sheath and placed up to 6.25 cm deep. After satisfactory samples were obtained, both needles were withdrawn in the control group, but in the treated group, the outer sheath was used to inject 0.5 ml of isobutyl 2-cyanoacrylate to seal the needle track. Pneumothorax was present in 7 (87.5%) of 8 dogs in the control group and in 2 (25%) of 8 dogs in the treated group (p = .0147). Lung tissue exhibited an apparent foreign-body granulomatous inflammatory reaction. This technique could extend the benefits of transthoracic needle biopsy to mechanically ventilated patients, but further studies to prove the safety of isobutyl 2-cyanoacrylate are necessary.
为探讨在接受呼气末正压通气（PEEP）机械通气的患者中安全进行经皮肺活检的可能性，对16只麻醉的杂种犬进行经胸针吸活检，这些犬以10 cm H₂O的PEEP进行机械通气。为获取活检样本，将一根25号“细针”穿过一根20号外套管，并插入至6.25 cm深。在获得满意的样本后，对照组将两根针均拔出，但治疗组则使用外套管注入0.5 ml异丁基2-氰基丙烯酸酯以封闭针道。对照组8只犬中有7只（87.5%）出现气胸，治疗组8只犬中有2只（25%）出现气胸（p = 0.0147）。肺组织呈现明显的异物性肉芽肿性炎症反应。该技术可将经胸针吸活检的益处扩展至机械通气患者，但有必要进行进一步研究以证明异丁基2-氰基丙烯酸酯的安全性。
