Tetracycline Pleurodesis During Active Pulmonary-Pleural Air Leak for Prevention of Recurrent Pneumothorax

Macoviak, John A.; Stephenson, Larry W.; Ochs, Rachel; Edmunds, L. Henry

doi:10.1378/chest.81.1.78

Cited by 50 publications

(21 citation statements)

References 10 publications

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“…Tetracycline can be recommended for recurrent primary and secondary pneumothorax when surgery is not an option, and graded talc may also be used on the grounds that it is the most effective agent in treating malignant pleural effusion and is also commonly used for surgical chemical pleurodesis 130–133. There is conflicting evidence as to whether tetracycline is effective for the treatment of a fully expanded pneumothorax with a persistent air leak 32 134 135. The largest of these studies, the Veterans Administration Study, did not support the use of intrapleural tetracycline to facilitate the closure of a persistent air leak 31.…”

Section: Medical Chemical Pleurodesismentioning

confidence: 99%

Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010

MacDuff

Arnold

Harvey

2010

Thorax

1,217

1,394

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Section: Medical Chemical Pleurodesismentioning

confidence: 99%

Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010

MacDuff

Arnold

Harvey

2010

Thorax

1,217

1,394

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“…For pneumothorax patients who are not good candidates for surgical treatment, chemical pleurodesis has been reported and accepted as a treatment (9)(10)(11)(12)(13). However, chemical pleurodesis is ineffective when the lungs of the patients are deflated.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Blood-Patch Pleurodesis for Secondary Spontaneous Pneumothorax in Interstitial Lung Disease

et al. 2011

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Objective We identified the prognostic relevance of pneumothorax in interstitial lung disease (ILD) patients and evaluated the efficacy and safety of autologous blood-patch pleurodesis. Methods We retrospectively reviewed 59 occurrences of pneumothorax in 34 ILD patients identified over a 12-year period. Results Air leakage ceased in 16 of 22 (72.7%) episodes after blood pleurodesis and in 11 of 14 (78.6%) episodes after chemical pleurodesis. Both the cure ratio and recurrence ratio in the cure episodes were comparable with those in the chemical pleurodesis group (p=0.99 and 0.99, respectively). In addition, there were no harmful events associated with blood pleurodesis. The median survival time after the first episode of pneumothorax was less than 9 months in patients with idiopathic interstitial pneumonia (IIP) and only around 3 years in the patients with other types of ILD, which have essentially favorable outcomes. Kaplan-Meier survival estimates were significantly worse in the patients with concomitant pneumomediastinum than in those without (p<0.05). A multivariate Cox regression analysis identified that the number of episodes of pneumothorax, IIP diagnosis and concomitant pneumomediastinum were independent predictors of death. Conclusion Autologous blood-patch pleurodesis is safe and worth considering as a first-line treatment for pneumothorax secondary to ILD. However, despite treatments, the prognosis after the onset of pneumothorax in ILD patients was found to be poor. In addition, concomitant pneumomediastinum may further worsen the prognosis.

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“…There are several procedures for treating persistent air leak, the most suitable being chosen on a patient-by-patient basis. Different types of sclerosant used in pleurodesis [2] include talc [3,4,5,6], antibiotics and antineoplastics [7,8,9] and autologous blood [10,11]. The surgical procedures include thoracoplasty, myoplasty, open pleural drainage, control by suturing or occlusion with biological agent [12].…”

Section: Introductionmentioning

confidence: 99%

Persistent Pleuropulmonary Air Leak Treated with Autologous Blood: Results from a University Hospital and Review of Literature

Oliveira

Catâneo²,

R³

et al. 2009

Respiration

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Background: Persistent air leak after pulmonary resection is a difficult complication for thoracic surgeons to manage. Objectives: To show the results of our experience treating persistent pleuropulmonary air leak with autologous blood and review the literature on this specific method of treatment. Methods: Retrospective study of patients with persistent aerial pleuropulmonary fistula treated with autologous blood. The patient’s own blood was collected from a peripheral vein and directly introduced through the pleural drain. An inverted siphon was located in the drainage system to avoid prolonged clamping of the drain. This siphon impeded blood return but not air escape. Results: Between January 2001 and August 2008, 27 patients were treated by the above method. Patient age ranged from 2 to 74 years, and 78% were male. Each procedure used a mean quantity of 92 ml blood. Mean persistent air leak time before pleurodesis was 10.6 days and mean time to fistula resolution after pleurodesis was 1.5 days. Twenty-three (85%) patients had persistent pleuropulmonary air leak closed with the above procedure. Conclusion: Treating persistent pleuropulmonary air leak with autologous blood is promising, but further studies are required to quantify its real effectiveness.

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Tetracycline Pleurodesis During Active Pulmonary-Pleural Air Leak for Prevention of Recurrent Pneumothorax

Cited by 50 publications

References 10 publications

Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010

Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010

Efficacy of Blood-Patch Pleurodesis for Secondary Spontaneous Pneumothorax in Interstitial Lung Disease

Persistent Pleuropulmonary Air Leak Treated with Autologous Blood: Results from a University Hospital and Review of Literature

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