Predictors of infectious complications of Endobronchial Ultrasonography with Transbronchial needle aspiration (EBUS-TBNA)

Aims: The aims of our study were to quantify the incidence of infectious complications in EBUS-TBNA, in a selected group of patients and try to identify the major risk factors. Material/Methods: Prospective + multicentre study, with patients submitted to an EBUS-TBNA. We collected clinical characteristics: presence of necrosis signs in radiology or EBUS image and mediastinal adenopathies evaluation. A post-procedure blood test, bronchoaspirate (BAS), blood cultures and chest X-ray were performed. All these tests repeated 48h late. Results: First 24h: 3 patients presented bacteremia and fever (1 pneumonia, 1 respiratory infection and 1 asymptomatic) and 4 presented fever without bacteremia (1 pneumonia and 3 asymptomatic). 48h: 1 presented fever and bacteremia developing a mediastinitis and 1 presented self-limited fever. After 30 days of follow-up: The rate of infectious complications was 6.4%. We identified a significant increase in white blood cell count (WBC) and C-reactive protein (CRP) in those patients. We analyzed the possible relationship between immunosuppression, the characteristics of the lesions, the number of punctures performed and the appearance of fever in the follow 48h, without significant association. A slight non-significant trend was observed at a higher risk of fever in >10 lymph nodes puncture (OR 3.9 (95% CI 0.80-19.24 p=0.092)), but not in other groups. Conclusions: The average of infectious complications was higher than those described in literature. A subgroup of susceptible patients could be identified. There was an WBC/CRP increase and a non-significant tendency of higher risk of fever in >10 lymph nodes puncture. Supported by SEPAR