Autologous blood pleurodesis for treatment of prolonged air leak in secondary spontaneous pneumothorax

2009 ◽  
Vol 25 (4) ◽  
pp. 188-191
Author(s):  
Manouchehr Aghajanzadeh ◽  
Hosin Hemati ◽  
Mohamad Reza Moghaddamnia ◽  
Gilda Aghajanzadeh
Keyword(s):  
Spontaneous Pneumothorax ◽  
Autologous Blood ◽  
Air Leak ◽  
Secondary Spontaneous Pneumothorax ◽  
Prolonged Air Leak

Applying Fibrin Glue under Pleurography for Intractable Secondary Spontaneous Pneumothorax

2019 ◽  
Author(s):  
Jeong Cho ◽  
Yeong Kim ◽  
Hoseok I. ◽  
Jung Eom ◽  
Hyo Ahn
Keyword(s):  
Fibrin Glue ◽  
Spontaneous Pneumothorax ◽  
Air Leakage ◽  
Air Leak ◽  
Short Term ◽  
Secondary Spontaneous Pneumothorax ◽  
Prolonged Air Leak ◽  
Postoperative Drainage ◽  
The Mean

Background Prolonged air leakage is a problem that can frequently develop in patients with a secondary spontaneous pneumothorax (SSP) or in those who undergo thoracic surgery. However, the management of an air leak is difficult and reoperation might be avoided due to several reasons including adhesions. Herein, we introduce a fibrin glue application under pleurography (FGAP) and short-term outcomes in patients who underwent this procedure. Methods FGAP was performed in 20 patients with an intractable persistent air leakage who had poor lung function, comorbidities to undergo general anesthesia and were expected severe adhesions due to previous surgery. All medical records were retrospectively reviewed. Results Eighteen cases sealed soon after dropping the glue. One patient had a prolonged air leak for 12 days and another patient required an operation to control air leakage 16 days after the procedure. The mean duration of postoperative drainage was 4.17 ± 2.11 days (range: 3–14 days). No postprocedural complications were recorded. The mean duration of follow-up was 12.01 ± 5.02 months (range: 4–22 months). Conclusion FGAP could be a treatment option to seal air leaks, especially in cases with intractable air leakage.

scholarly journals Autologous blood-patch pleurodesis for secondary spontaneous pneumothorax with persistent air leak

1999 ◽  
Vol 93 (6) ◽  
pp. 432-434 ◽  
Author(s):  
M. ANDO ◽  
M. YAMAMOTO ◽  
C. KITAGAWA ◽  
A. KUMAZAWA ◽  
M. SATO ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Autologous Blood ◽  
Air Leak ◽  
Secondary Spontaneous Pneumothorax ◽  
Blood Patch ◽  
Persistent Air Leak

Autologous Blood Patch Pleurodesis for the Management of a Persistent Air Leak after Secondary Spontaneous Pneumothorax

Respiration ◽  
2021 ◽  
pp. 1-5
Author(s):  
Jane A. Shaw ◽  
Elisma Wilken ◽  
Brian W. Allwood ◽  
Elvis M. Irusen ◽  
Coenraad F.N. Koegelenberg
Keyword(s):  
Spontaneous Pneumothorax ◽  
Autologous Blood ◽  
Treatment Options ◽  
Case Series ◽  
Cost Effective ◽  
Air Leak ◽  
Secondary Spontaneous Pneumothorax ◽  
Blood Patch ◽  
Successful Group ◽  
Persistent Air Leak

Patients with secondary spontaneous pneumothorax (SSP) complicated by persistent air leak (PAL) and who are poor surgical candidates have limited treatment options. This case series explored autologous blood patch pleurodesis as a possible cost-effective management option. A total of 46 episodes of SSP with PAL were included. The procedure was successful in 33 (71.7%). Of these, 17 (51.5%) resolved within 1 day. The mean duration of intercostal drainage prior to the blood patch was 22 days in the successful group. Pneumothoraces with incomplete lung re-expansion at the time of procedure were successful in 20 of 30 (66.7%). Only human immunodeficiency virus infection was associated with failure (<i>p</i> = 0.03). Adverse events included transient fever (<i>n</i> = 3) that resolved spontaneously, and empyema (<i>n</i> = 3) which were successfully managed with antibiotics and pigtail drainage. We conclude that a large proportion of patients with SSP complicated by PAL who are unfit for surgery may be liberated from intercostal drainage by an autologous blood patch pleurodesis, with minimal adverse effects.

Autologous Blood Pleurodesis: What Is the Optimal Time Interval and Amount of Blood?

2021 ◽  
Author(s):  
Alessio Campisi ◽  
Andrea Dell'Amore ◽  
Yonghui Zhang ◽  
Zhitao Gu ◽  
Angelo Paolo Ciarrocchi ◽  
...  
Keyword(s):  
Chest Tube ◽  
Autologous Blood ◽  
Optimal Time ◽  
Time Interval ◽  
Air Leak ◽  
Increased Risk ◽  
Tube Removal ◽  
Blood Patch ◽  
Prolonged Air Leak ◽  
Chest Tube Removal

Abstract Background Air leak is the most common complication after lung resection and leads to increased length of hospital (LOH) stay or patient discharge with a chest tube. Management by autologous blood patch pleurodesis (ABPP) is controversial because few studies exist, and the technique has yet to be standardized. Methods We retrospectively reviewed patients undergoing ABPP for prolonged air leak (PAL) following lobectomy in three centers, between January 2014 and December 2019. They were divided into two groups: Group A, 120 mL of blood infused; Group B, 60 mL. Propensity score-matched (PSM) analysis was performed, and 23 patients were included in each group. Numbers and success rates of blood patch, time to cessation of air leak, time to chest tube removal, reoperation, LOH, and complications were examined. Univariate and multivariate analysis of variables associated with an increased risk of air leak was performed. Results After the PSM, 120 mL of blood is statistically significant in reducing the number of days before chest tube removal after ABPP (2.78 vs. 4.35), LOH after ABPP (3.78 vs. 10.00), and LOH (8.78 vs. 15.17). Complications (0 vs. 4) and hours until air leak cessation (6.83 vs. 3.91, range 1–13) after ABPP were also statistically different (p < 0.05). Air leaks that persisted for up to 13 hours required another ABPP. No patient had re-operation or long-term complications related to pleurodesis. Conclusion In our experience, 120 mL is the optimal amount of blood and the procedure can be repeated every 24 hours with the chest tube clamped.

Intrapleural Instillation of Autologous Blood in the Treatment of Prolonged Air Leak After Lobectomy: A Prospective Randomized Controlled Trial

2006 ◽  
Vol 82 (3) ◽  
pp. 1052-1056 ◽  
Author(s):  
Michael J. Shackcloth ◽  
Michael Poullis ◽  
Mark Jackson ◽  
Ajaib Soorae ◽  
Richard D. Page
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Autologous Blood ◽  
Air Leak ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Prolonged Air Leak

scholarly journals Analysis of pneumothorax recurrence risk factors in 843 patients who underwent videothoracoscopy for primary spontaneous pneumothorax: results of a multicentric study

2020 ◽  
Vol 31 (1) ◽  
pp. 78-84
Author(s):  
Maria Cattoni ◽  
Nicola Rotolo ◽  
Maria Giovanna Mastromarino ◽  
Giuseppe Cardillo ◽  
Mario Nosotti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spontaneous Pneumothorax ◽  
Primary Spontaneous Pneumothorax ◽  
Chest Drain ◽  
Air Leak ◽  
Old Patients ◽  
Multicentric Study ◽  
Prolonged Air Leak ◽  
Pleural Abrasion

Abstract OBJECTIVES Risk factors for pneumothorax recurrence after videothoracoscopy for primary spontaneous pneumothorax are still being debated. The goal of this study was to assess whether the pleurodesis technique and other variables are possibly associated with the postoperative ipsilateral recurrence of pneumothorax. METHODS We retrospectively collected data of 1178 consecutive ≤40-year-old patients who underwent videothoracoscopy for primary spontaneous pneumothorax in 9 centres between 2007 and 2017. We excluded patients with hybrid pleurodesis and/or incomplete follow-up, leaving for analysis 843 cases [80% men; median age (interquartile range) 22 (18–28) years]. Univariable and multivariable analyses were performed by logistic regression and tested by Cox regression model to assess factors related to ipsilateral pneumothorax recurrence including age, gender, body mass index, smoking habit, cannabis smoking, respiratory comorbidity, dystrophic severity score, surgical indication, videothoracoscopy port number and side, lung resection, pleurodesis technique and postoperative prolonged air leak (&gt;5 days). RESULTS Blebs/bullae resection was performed in 664 (79%) patients. Pleurodesis was achieved by partial pleurectomy in 228 (27%) cases; by pleural electrocauterization in 176 (21%); by pleural abrasion in 121 (14%); and by talc poudrage in 318 (38%). During a median follow-up period of 70.0 months (95% confidence interval 66.6–73.4), pneumothorax recurred in 79 patients (9.4%); among these, 29 underwent redo surgery; 34, chest drain/talc slurry; and 16, clinicoradiological observation. The only independent risk factor for recurrence was postoperative prolonged air leak (P &lt; 0.001) that was significantly related to blebs/bullae resection (P = 0.03). CONCLUSIONS In this multicentric series, postoperative ipsilateral pneumothorax recurrence was remarkable and independently related to prolonged postoperative air leak; besides the retrospective study setting, the pleurodesis method did not have an impact on recurrence. To prevent prolonged air leak, blebs/bullae treatment should be accurate and performed only if indicated.

Video assisted thoracoscopic management of primary spontaneous pneumothorax

2020 ◽  
pp. 1-14
Author(s):  
Farhan Ahmed Majeed ◽  
Yasser Saeed Khan ◽  
Ahmed Raza ◽  
Tashfeen Imtiaz ◽  
Usama Zafar ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Case Series ◽  
Primary Spontaneous Pneumothorax ◽  
Definitive Treatment ◽  
Parietal Pleura ◽  
Air Leak ◽  
Video Assisted ◽  
Stage 4 ◽  
Prolonged Air Leak ◽  
Partial Pleurectomy

Abstract Objective: To analyze the outcome of Video assisted Thoracoscopy (Vats) in Primary Spontaneous Pneumothorax (PSP). Methods: This case series was carried out from Jan 2010 to Jan 2017 in Dept of Thoracic Surgery CMH Rawalpindi and Lahore. A total of 98 patients underwent Video-assisted thoracoscopic for PSP.  Inclusion criteria were physiologically fit patients with PSP for recurrent attacks, occupational hazards and prolonged air leak. Exclusion criteria included secondary spontaneous pneumothorax, previous pleurodesis and physiologically unfit patient for general anesthesia. Vanderschueren's thoracoscopic classification was used for macroscopic staging. A 3-port technique was used for apical stapling with partial pleurectomy up to 6th rib. Parietal pleura and diaphragm was also abraded. Results: Occupational hazard was the commonest indication for surgery, n= 39 (39.7%). This was followed by recurrent pneumothorax n=37 (37.7%), persistent air leak n= 19 (19.38%), and contra lateral pneumothorax n=4 (4.08). Mean age was 22.8 years ± 6.5. Majority of the cases were in stage 3 of Vanderschueren’s  classification, n=69 (70.4%). Stage 4 were n= 18 and stage 2 were n=7. Mean operative time was 51minutes ±14.4. Postoperative prolonged air leak occurred in 3 patients and post-operative neuralgia occurred in 8 patients. Mean follow-up was 22 months ± 5.5, range 5-24 months for all patients. One had generalized recurrence and 2 patients have subpulmonic trapping of air. Conclusions: Video-assisted thoracoscopic stapling and pleurectomy is an effective definitive treatment for primary spontaneous pneumothorax when indicated with minimal recurrence. Keywords: Video-assisted thoracoscopy, blebs, pneumothorax. Continuous...

Efficacy of an autologous blood patch for prolonged air leak, a systematic review

2021 ◽  
Author(s):  
Niek Hugen ◽  
Edo J. Hekma ◽  
Niels J.M. Claessens ◽  
Hans J.M. Smit ◽  
Michel M.P.J. Reijnen
Keyword(s):  
Systematic Review ◽  
Autologous Blood ◽  
Air Leak ◽  
Blood Patch ◽  
Prolonged Air Leak

The utility of intrapleural instillation of autologous blood for prolonged air leak after lobectomy

2008 ◽  
Vol 14 (4) ◽  
pp. 343-347 ◽  
Author(s):  
Aneez Ahmed ◽  
Richard D Page
Keyword(s):  
Autologous Blood ◽  
Air Leak ◽  
Prolonged Air Leak
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