Wednesday, December 14, 2005

Bronchs and coag's

This comes up fairly often in patients with AFib, mechanical heart valves and liver disease who need bronch's. What is your comfortable cutoff for PT-INR and or platelets when doing a bronchoscopy? Is there any good data on safety and cutoff levels?

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Mike L said...

Papin TA, Lynch JP 3rd, Weg JG. Transbronchial biopsy in the thrombocytopenic patient.
Chest. 1985 Oct;88(4):549-52

This article (recognize any of the authors) states it is safe to do TBBx without worry to 25K.
Scary, huh?
I know that JPL did not really believe the results and "preferred" platelets at levels close to 100K.

I am not sure if there is anything on coags and bronchoscopy.