Extracorporeal Life Support For Status Asthmaticus

cannula, a curette needle, and a hollow bevelled needle with an inner removable stylet. The shaving action of the cannula over the curette after it has engaged the pleura is the recommended technique of pleural biopsy. The Abrams' needle consists of two main concentric tubes:3 the outer hollow trocar has a deep notch proximal to the tip and the cutting action of the inner hollow tube as it is advanced samples the pleura. The absence of an outer cannula mandates that the Abrams' needle, unlike Cope's, must be removed and reinserted with each biopsy attempt. We report a rare, although important complication of closed needle pleural biopsy-breakage or bending of the hooked end of Cope's needle that occurred recently on four separate occasions at our institution. In each case, difficulty was noted while trying te remove the curette from the cannula after closed pleural biopsy, prompting removal of the curette and cannula together. On one occasion, however, the tip of the curette broke off immediately after removal of the needle from the patient's chest (Fig 1). In three other instances, the tip was visibly bent. Fortunately, none of these patients suffered any ill effects.