Is Longpunksie-aspirasie' 'n Onskuldige Prosedure?

Abstract

Diagnostic lung punctures were done with parental consent in 29 previously untreated children aged 2 months to 9 years (median age 16 months), with radiologically proved broncho- or lobar pneumonia. Radiological examination was repeated after the procedure. Positive bacteriological cultures were obtained in 5 cases (17,2%): H. influenzae (2), a-haemolytic streptococci (2),  and D. pneumoniae (1). Six patients (20,7%) developed overt pneumothorax and 1 had haemoptysis. All 7 patients recovered completely. Pneumothorax occurred in 5 of the 6 patients during the first 19 aspirations carried out by 6 different operators, while no local anaesthesia was used. The subsequent 11 punctures, among which only one case of pneumothorax occurred, were done by one person only after infiltration of the site with local anaesthetic. The incidence of pneumothorax seems to relate to the experience and skill of the operator, possibly to the use of local anaesthetic, and most important, whether identified by means of routine radiological examination after the procedure. Lung puncture does not appear to be an invariably innocuous procedure and should probably be reserved for special cases where uncommon aetiological agents are anticipated, for instance intractable pneumonitis accompanying immunodeficiency disease, the use of immunosuppressives, or with malignancy.

S. Afr. Med. J. 48, 597 (1974)