Application of autologous blood patch in patients with non-expanded lungs and persistent air leak

Abstract

Background: This study aims to evaluate the effectiveness of pleurodesis procedure by ensuring the expansion of the lung and occluding lung parenchyma leaks with an autologous blood patch. Methods: A total of 24 patients (17 males, 7 females; mean age 59.9±12.2 years; range, 30 to 86 years) who underwent autologous blood patch pleurodesis in our clinic between November 2015 and November 2019 were retrospectively analyzed. The patients were not eligible to undergo chemical pleurodesis due to a non-expandable lung or poor general condition. Demographic and clinical characteristics of the patients and postoperative data were evaluated. Results: The air leak stopped within 48 h after autologous blood patch pleurodesis in seven patients. The air leak significantly decreased in 13 patients, while it remained unchanged in four patients. A Heimlich valve was placed in the patients in whom the air leak stopped or significantly decreased. The follow-up chest X-rays showed that the respective lungs of these patients became completely expandable. Conclusion: Our study results suggest that the autologous blood patch procedure is a favorable option for the patients who are unable to benefit much from the conventional chemical pleurodesis methods due to contraindications to surgery or the presence of non-expandable lungs.

The Use of Autologous Blood Patch in Ullrich Muscular Dystrophy and Recurrent Pneumothorax

“…The main side effects reported are fever and empyema. Of note, the procedure is usually painless, and no sedatives or analgesics are needed [10]. In their research, Oliveira et al found other studies with an 84-100% success rate for autologous blood patches for persistent air leaks, including their own success rate of 85% [4].…”

“…Surgical treatment and pleurodesis are commonly performed to overcome a pneumothorax [1,10]. In chemical pleurodesis, agents such as talc powder, tetracycline derivatives, and bleomycin are used to eliminate the space between the parietal and visceral pleura and, thus, seal the air leak [10].…”

“…Surgical treatment and pleurodesis are commonly performed to overcome a pneumothorax [1,10]. In chemical pleurodesis, agents such as talc powder, tetracycline derivatives, and bleomycin are used to eliminate the space between the parietal and visceral pleura and, thus, seal the air leak [10]. To achieve success with chemical pleurodesis, the lung must have begun to expand, and the pleural layers should be spaced close enough to allow adhesion [11].…”

“…The autologous blood patch procedure was first used in 1987 to repair persistent pneumothorax [12]. In this form of pleurodesis, blood is inserted through a patient's chest tube and a clot begins to form [10]. Then, the fibrogenic activity of the blood generates pleurodesis by inducing pleural irritation and inflammation [13].…”

“…Over time, this method prevents further episodes and improves lung expansion. In the literature, side effects and complications of the autologous blood patch procedure are significantly less when compared with chemical pleurodesis [10]. The main side effects reported are fever and empyema.…”