Published Paper Details:

Background: Pneumothorax is a common complication of navigational bronchoscopy for peripheral lung biopsies, occurring in 5-15% of cases. While high-concentration oxygen is known to accelerate resolution of spontaneous pneumothorax via nitrogen washout, its proactive intraoperative use as a mitigation strategy during bronchoscopy remains unexplored. Case Summary: A 56-year-old woman with a history of breast cancer underwent navigational bronchoscopy for biopsy of a 6-mm right middle lobe nodule. High-concentration oxygen was administered throughout the procedure. A moderate post-procedural pneumothorax was detected on chest X-ray but resolved significantly within 3 hours and completely by 24 hours without chest drain insertion. Serial imaging confirmed full resolution at 21-day follow-up. Conclusion: This case suggests that intraoperative high FiO? may harness the nitrogen washout effect to rapidly resolve iatrogenic pneumothorax, potentially avoiding invasive intervention. We propose a risk-stratified framework to guide targeted use--positioning oxygen not merely as a ventilatory support, but as an active safety lever in bronchoscopic lung biopsy.