Effect of oxygen therapy on increasing PaO2 in hypoxemic patients with stable COPD while breathing ambient air.

(1tIite far in the direction of the hilus. Immediately after tearing off the fragment, profuse bleeding had occurred. Aspiration and the “bleeding lung down” maneuver were able to handle the situation until the bleeding spontaneously subsided. Recsvery was uneventfill. In Ofl case, microscopy showed a mediumn-sized ulIn0na, arters: Life-threatening bleeding has been attributed to biopsy of a sizable pulmonary or bronchial artery23 Although it has been stated that such an event is unpredictable,2 our experience shows that at least 5OfllC of those bleedings can be avoided. Transtracheal biopsy should be performed in the outer p )rti n (cortex) of the lung parenchyma. Advancing the forceps too far can lead to severance of the pleura, resulting in pneumnothorax;2 advancing the forceps not far enough can lead to biopsy of the larger bronchovascular bundles in the more central (medullar) part of the lung, resulting in severe bleeding. The resistance felt whelm withdrawing the forceps (which, of course, demands experience) and the fluoroscopic findings can give a warning sign that such an event could occur; it wotlld then seem prudent to release the grasp of the forceps and to biopsy at another place. This culd also be a reason for the routine use of fluoroscopy during transhronchial biopsy