Contraindications
Relative contraindications are as follows:
- Single Lung:
You cannot afford any complications at all.
It is best to use clinical
judgement for all management decisions.
- Pulmonary Hypertension:
The risk of bleeding from a core
biopsy is high in patients
with pulmonary hypertension and should be avoided. We probably can
get by with a skinny
needle aspiration!
- Bleeding Diathesis:
Bleeding diathesis is certainly a
contraindication for any form
of biopsy.
- COPD, Bullae and Respiratory Failure:
The risk of pneumothorax is higher in patients
with COPD and blebs.
However, it is only a relative contraindication. If the patient
has respiratory failure, the
procedure should be done as an inpatient and the chest evacuated
even for a minor
pneumothorax.
- Uncooperative Patient:
While an echinococcus cyst and AV malformation are
contraindications, there is no indication to start
with. Anaphylactic reaction can follow rupture of an echinococcus cyst.
Therefore, needle aspiration
should not be done if this diagnosis is a possibility.