Endobronchial Ultrasound (EBUS) with Transbronchial Needle Aspirate (TBNA) is widely used today to evaluate patients with hilar or mediastinal lymphadenopathy. The risk of complications associated with the procedure is usually very low, making it an attractive choice for diagnosis and staging.


Hazards of EBUS-TBNA:

(1) hemorrhage (hemomediastinum, massive hemoptysis, hematoma)

(2) infection (pericarditis, mediastinal abscess, bacteremia)

(3) pneumothorax or pneumomediastinum


Factors associated with an increased risk of complications:

(1) inexperienced operator

(2) device malfunction

(3) repeated needle entries at a single spot


Factors associated with hemorrhage:

(1) anticoagulation

(2) penetration of a large blood vessel


Factors associated with infection:

(1) immunosuppression

(2) introduction of oropharyngeal bacteria into a necrotic or poorly vascularized space

(3) failure to properly clean the equipment after use


A patient at increased risk for an infectious complication may benefit from prophylactic antibiotics prior to the procedure.


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