Preparation Before The Biopsy

How is the Patient Prepared for the Lung Biopsy Procedure?

Before the biopsy is performed, it is important to thoroughly evaluate the patient.

Investigations done before the biopsy procedure-

Before the biopsy is performed, it is important to thoroughly evaluate the patient for-

• Concomitant medication / illness

• Any drug allergy
• Past history of bleeding / clotting problems
• Pregnant status- Biopsy should not be performed in pregnant women
• Any primary lung diseases (cor pulmonale)

Biopsy is contraindicated in a patient with bullae (enlarged alveoli associated with emphysema), cysts, severe hypoxia (insufficient concentration of oxygen in blood) or pulmonary hypertension.

Tests commonly done before a biopsy procedure are:

• Routine blood investigations
• Platelet count is commonly done to check if the individual’s bleeding and clotting parameters are within normal limits. For those with counts lower than 50,000/cubic mm, a platelet transfusion would be required before the biopsy.
• Chest X-ray - To locate the exact biopsy site
• An arterial blood gas and a pulmonary function test may also be done.

Patient preparation before the biopsy-

• The patient is asked to avoid aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or blood thinners such as warfarin for a week before the procedure.
• Patient consent for the procedure is obtained.
• The patient should be on nil oral for a period of 12 hours before the biopsy.
• Sometimes, medications may be prescribed to dry up secretions in the mouth and airways.
• The patient is asked not cough during the biopsy procedure.
• The patient may be intubated to allow proper breathing during the biopsy procedure.
• Local anesthesia is injected into the site of the biopsy.
• The patient is asked to sit in a relaxed position with arms resting forward on a table. The biopsy is performed using a suitable procedure. Pressure is placed over the site after the biopsy procedure. A chest x-ray is taken after the biopsy. The results are obtained after a few days.