A prospective study of autologous ?blood patch? pleurodesis for persistent air leak after pulmonary resection

Abstract

In our experience a single injection of 50 ml of blood is sufficient to seal persistent air leaks in less than 48 h. Although highly effective, the autologous blood patch pleurodesis technique should not be used in patients with incomplete lung re-expansion or positive pleural fluid culture to minimize the risk of empyema.

Autologous blood patching in the management of broncho-pleural fistula in spontaneous pneumothorax

“…Prior reports 19 have demonstrated upto 28% (3/28) rates of empyema and nearly 20% (2/11) rates of fever. 8 Three of our 76 (4%) developed pleural infection which although significant is much smaller complication rate than previously reported. We followed an absolute adherence to the contraindications and made the effort to rule out pre-existing infection.…”

“…This device not only connected the chest tube to the drainage system but also provided an extra port with a cap which was used to introduce the blood into the chest in a sterile fashion without having to make a needle stick hole in the chest tube itself or having to even temporarily disconnect the tube from the drainage pipe which has been described by others. 8 The drainage tube itself was also lengthened with the addition of another two meter tubing. This was done to allow adequate length for the tube be looped over an Intravenous (IV) stand.…”

“…5 Many subsequent authors have described its use in management of PAL after pulmonary resections and after hydatid cyst operations [6][7][8][9] The success of ABP has been varied in reported literature with success rate as low as 27% and also upto72-100%. [10][11][12] We conducted this study to evaluate the success rate of ABP in a large population of patients with BPF of spontaneous onset.…”

Surgical Management of Prolonged Air Leak in Patients with Underlying Emphysema

“…Several small observational studies have demonstrated the efficacy and safety of autologous blood in treating post-operative prolonged air leak (108)(109)(110). In these studies, patients with prolonged air leak (>5-10 days) after undergoing a variety of operations (lobectomy, wedge resection, bullectomy, lung volume reduction or decortication) were treated with 1-2 injections of autologous blood pleurodesis with resolution of air leak in all patients within 48 hours of therapy.…”

“…A variety of agents have been described for this purpose, including silver nitrate(100), quinacrine(101), minocycline(102), tetracycline (103), doxycycline(104), erythromycin (105), bleomycin (106), iodopovidone(107), talc powder (14) and autologous blood (108)(109)(110)(111). Be that as it may, contemporary literature has mainly focused on autologous blood for treatment of persistent post-operative air leaks, so the utility of the other agents for this clinical context are not as well known.…”