• Haruka Chino, Motoyasu Iikura, Nayuta Saito, Nahoko Sato, Manabu Suzuki, Satoru Ishii, Eriko Morino, Go Naka, Jin Takasaki, Shinyu Izumi, Masayuki Hojo, Yuichiro Takeda, and Haruhito Sugiyama.
• Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan. hchino-tky@umin.ac.jp.
• Respir Care. 2016 Dec 1; 61 (12): 1664-1670.

BackgroundPneumothorax is one of the most important complications after bronchoscopy. This study was conducted to determine the risk factors for post-bronchoscopy pneumothorax.MethodsWe retrospectively reviewed the medical records of 23 consecutive subjects who were diagnosed with iatrogenic pneumothorax after bronchoscopy between August 2010 and February 2014. Forty-six control subjects who did not develop pneumothorax after bronchoscopy were randomly selected. The factors affecting the occurrence of pneumothorax were determined by univariate and multivariate analyses.ResultsAmong 991 patients who underwent bronchoscopy during the study period, 23 (2.3%) developed pneumothorax after bronchoscopy. Among these 23 subjects, 13 (57%) required chest tube drainage. Compared with the control group (46 randomly selected from 968 subjects who did not develop pneumothorax), the group that developed pneumothorax had a preponderance of women and had more target lesions located in the subpleural area (odds ratio [OR] 7.8, 95% CI 0.9-64), especially those that were close to the interlobular pleura (OR 5.1, 95% CI 1.6-16.1) and the left lung (OR 3.2, 95% CI 1.1-9.5). Multivariate analysis revealed that a subinterlobular pleural location of a lesion was a risk factor for pneumothorax (OR 4.8, 95% CI 1.1-20.4).ConclusionsPneumothorax occurred significantly more frequently when bronchoscopy was performed for subinterlobular pleural lesions. Close attention and care should be taken during bronchoscopy, especially when target lesions are abutting the interlobular pleura.Copyright © 2016 by Daedalus Enterprises.

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