The Treatment of Refractory Pneumothorax in Diffuse Panbronchiolitis by Intravenous Administration of Coagulation Factor XIII Concentrate

Murata, Akira; Kouno, Ayumi; Yamamoto, Kazuo; Yoshioka, Hiroko; Kida, Kenji; Kudoh, Shoji

doi:10.1272/jnms.73.89

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…Additionally, plasma factor XIII has been reported to be a fistula-healing factor and intraoperative bleeding (29,30,45,46). In lung disease, there are some reports related to therapeutic effect of pneumothorax and prolonged air leak after pulmonary lobectomy (47,48). However, effect of plasma factor XIII is controversial (49).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and failure factors of manual aspiration using a small needle for large pneumothorax in stable patients

Homma¹,

Ojima²,

Shimada³

et al. 2022

J Thorac Dis

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Background: Manual aspiration as the initial management of a large pneumothorax in a clinically stable patient has been reported to be safe and effective. However, the effect with smaller needles, the number of aspiration, the indication other than spontaneous pneumothorax and failure factors are unknown. We assessed the effectiveness and failure risk factors of manual aspiration up to three using a 20-or 22-gauge (G) needle in patients with a large, clinically stable pneumothorax.Methods: We included 107 clinically stable patients with large pneumothorax. Patients who were unstable, required a ventilator, underwent chest tube drainage or had an observed small pneumothorax, bilateral pneumothorax, hemopneumothorax, or postoperative pneumothorax were excluded. Up to three aspirations were performed using 20-or 22-G intravenous needles. When the aspiration volume was ≥2,500 mL or lung expansion did not occur, a chest tube was placed. Results:The first aspiration was successful in 57 patients (53.3%), the second in 16 patients (59.3%), and the third in eight patients (80.0%). No patient experienced any obvious complications or required emergent hospitalization or surgery after aspiration. Aspiration failure was correlated with an inter-pleural distance >20 mm at the level of the hilum (odds ratio: 4.93; 95% confidence interval: 1.49-22.71; P=0.0075), spontaneous secondary pneumothorax (odds ratio: 3.11; 95% confidence interval: 1.14-8.76; P=0.027), and ≤24 h from onset to presentation (odds ratio: 2.95; 95% confidence interval: 1.12-8.26; P=0.028). There were no significant differences in intrathoracic pressure after aspiration or plasma factor XIII levels between patients with resolved and persistent pneumothorax.Conclusions: Manual aspiration up to three times using a small needle might be one of a treatment option in clinically stable patients with any large pneumothorax. Aspiration failure was correlated with an inter-pleural distance >20 mm at the level of the hilum, spontaneous secondary pneumothorax, and ≤24 h from onset to presentation.

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Section: Discussionmentioning

confidence: 99%

Effectiveness and failure factors of manual aspiration using a small needle for large pneumothorax in stable patients

Homma¹,

Ojima²,

Shimada³

et al. 2022

J Thorac Dis

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show abstract

“…If air leakage persists for more than 2 days, we should start to check whether the patient can tolerate an operation under general anesthesia and consult with the thoracic surgeon and anesthesiologist. When the patient cannot endure an operation, other treatments such as pleurodesis, endoscopic bronchial occlusion, and intravenous coagulation factor XIII concentrate therapy should be considered (9,10).…”

Section: Decision To Perform Surgerymentioning

confidence: 99%