Role of Surgical Glue in Persistent Air Leak in Spontaneous Pneumothorax

Abstract Background: Conservative observation with/without oxygen supplementation, aspiration, or tube drainage is selected as an initial treatment for spontaneous pneumothorax. In this study, we have examined the efficacy of initial management for cessation of air leak and prevention of recurrence separately, with consideration of the degree of lung collapse.Methods: Spontaneous pneumothorax in patients who underwent initial management in our institute between January 2006 and December 2015 were included in this retrospective, single-institutional study. Multivariate analyses were conducted to identify risk factors related to the persistent air leak after initial treatment and those related to ipsilateral recurrence after last treatment.Results: In the multivariate analysis for predicting persistent air leak after first treatment, repeated episode of ipsilateral pneumothorax (p = 0.0022), high degree of lung collapse (p = 0.032), and bulla formation (p < 0.0001) were the statistically significant risk factors for treatment failure. Recurrence of ipsilateral pneumothorax was observed in 126 cases. In the multivariate analysis for predicting the recurrence, repeated episode of ipsilateral pneumothorax was the significant risk factor (p = 0.0032).Conclusions: Predicting factors for persistent air leak after initial treatment were recurrence of ipsilateral pneumothorax, high degree of lung collapse, and radiological evidence of bullae. The predictive factor for recurrence after the last treatment was recurrence of ipsilateral pneumothorax. Selection of either observational or interventional approach at initial management did not affect the outcomes evaluated. Therefore, because of treatment invasiveness, observation is recommended to be attempted first in cases sans risk factors.Trial Registration: retrospectively registeredDate of IRB approval: May 28, 2018Number of IRB approval: 2017320

Download Full-text

Intrapleural instillation of autologous blood for persistent air leak in spontaneous pneumothorax- is it as effective as it is safe?

Journal of Cardiothoracic Surgery ◽

10.1186/1749-8090-5-61 ◽

2010 ◽

Vol 5 (1) ◽

Cited By ~ 7

Author(s):

Dimos Karangelis ◽

Georgios I Tagarakis ◽

Marios Daskalopoulos ◽

Georgios Skoumis ◽

Nicholaos Desimonas ◽

...

Keyword(s):

Spontaneous Pneumothorax ◽

Autologous Blood ◽

Air Leak ◽

Persistent Air Leak

Download Full-text

RESOLUTION OF PERSISTENT AIR LEAK DUE TO SECONDARY SPONTANEOUS PNEUMOTHORAX WITH A NOVEL ATRIUM SUSPENSION TECHNIQUE

CHEST Journal ◽

10.1016/j.chest.2020.08.1134 ◽

2020 ◽

Vol 158 (4) ◽

pp. A1245

Author(s):

Zaith Bauer ◽

Whittney Warren

Keyword(s):

Spontaneous Pneumothorax ◽

Air Leak ◽

Secondary Spontaneous Pneumothorax ◽

Persistent Air Leak

Download Full-text

Chest-tube digital assessment after pulmonary resection: the crucial role of time-trend analysis and a new model to predict a persistent air leak

European Journal of Cardio-Thoracic Surgery ◽

10.1016/j.ejcts.2010.07.020 ◽

2011 ◽

Vol 39 (3) ◽

pp. 436-437

Author(s):

Filippo Lococo ◽

Alfredo Cesario ◽

Stefano Margaritora ◽

Pierluigi Granone

Keyword(s):

Trend Analysis ◽

Chest Tube ◽

Crucial Role ◽

Time Trend ◽

Pulmonary Resection ◽

Air Leak ◽

New Model ◽

Digital Assessment ◽

Persistent Air Leak

Download Full-text

Management des Spontanpneumothorax: Die Therapieentscheidung mit digitaler pleuraler Manometrie beeinflussen

Karger Kompass Pneumologie ◽

10.1159/000508010 ◽

2020 ◽

Vol 8 (3) ◽

pp. 150-151

Author(s):

Stefanie Keymel

Keyword(s):

Clinical Study ◽

Spontaneous Pneumothorax ◽

Clinical Impact ◽

Air Leak ◽

Chest Drainage ◽

Initial Management ◽

Intrapleural Pressure ◽

Mean Pressure ◽

The Mean ◽

Persistent Air Leak

Background: The initial management of pneumothorax remains controversial, and we speculated that this might be because there is no method available for evaluation of air leak during initial management. We have developed a system for measurement of intrapleural pressure in pneumothorax to address air leak without the need for chest drainage. The aim of this clinical study was to confirm the ability of this measurement system and to determine the clinical impact of management of air leak. Methods: Patients in whom need aspiration was indicated for spontaneous pneumothorax were enrolled in the study. The intrapleural pressure was measured during stable breathing and data recorded when patients were coughing were excluded. Results: Eleven patients were enrolled in the study between December 2016 to July 2017. The patterns in change of intrapleural pressure varied widely depending on the state of the pneumothorax. The mean intrapleural pressure values on end-inspiration and end-expiration in patients with persistent air leak was significantly lower than those in patients without persistent air leak (p = 0.020). The number of negative mean pressure recordings in endinspiration and end-expiration was significantly lower in patients with persistent air leak than in those without persistent air leak (p = 0.0060). Conclusions: In this study, we demonstrated that intrapleural pressure could be successfully measured and visualized in patients with pneumothorax. Whether or not the pressure value is a predictor of persistent air leak needs to be confirmed in the future.

Download Full-text

Measurement of intrapleural pressure in patients with spontaneous pneumothorax: a pilot study

BMC Pulmonary Medicine ◽

10.1186/s12890-019-1038-9 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Hiroyuki Kaneda ◽

Takahito Nakano ◽

Tomohiro Murakawa

Keyword(s):

Clinical Study ◽

Spontaneous Pneumothorax ◽

Clinical Impact ◽

Air Leak ◽

Chest Drainage ◽

Initial Management ◽

Intrapleural Pressure ◽

Mean Pressure ◽

The Mean ◽

Persistent Air Leak

Abstract Background The initial management of pneumothorax remains controversial, and we speculated that this might be because there is no method available for evaluation of air leak during initial management. We have developed a system for measurement of intrapleural pressure in pneumothorax to address air leak without the need for chest drainage. The aim of this clinical study was to confirm the ability of this measurement system and to determine the clinical impact of management of air leak. Methods Patients in whom need aspiration was indicated for spontaneous pneumothorax were enrolled in the study. The intrapleural pressure was measured during stable breathing and data recorded when patients were coughing were excluded. Results Eleven patients were enrolled in the study between December 2016 to July 2017. The patterns in change of intrapleural pressure varied widely depending on the state of the pneumothorax. The mean intrapleural pressure values on end-inspiration and end-expiration in patients with persistent air leak was significantly lower than those in patients without persistent air leak (p = 0.020). The number of negative mean pressure recordings in end-inspiration and end-expiration was significantly lower in patients with persistent air leak than in those without persistent air leak (p = 0.0060). Conclusions In this study, we demonstrated that intrapleural pressure could be successfully measured and visualized in patients with pneumothorax. Whether or not the pressure value is a predictor of persistent air leak needs to be confirmed in the future.

Download Full-text