Open lung biopsy in patients with respiratory failure

Open lung biopsy (OLB) is known as a gold standard for the definitive diagnosis of parenchymal lung diseases acute or chronic, localised or diffused. It has high diagnostic yield over brochio-alveolar lavage (BAL) and trans-bronchial needle biopsy (TBB). The use of the OLB in non-intensive care unit patients is considered as a relatively safe technique but the use of OLB in critically ill patients and ICU patients is not well studied and unclearly defined. Large randomised study should be performed to precise the benefits, value and outcome of the employment of OLB in critically ill patients with undiagnosed respiratory failure.