Use of One-Way Intrabronchial Valves in Air Leak Management After Tube Thoracostomy Drainage

Gilbert, Christopher R.; Casal, Roberto F.; Lee, Hans J.; Feller‐Kopman, David; Frimpong, Bernice; Dinçer, H. Erhan; Podgaetz, Eitan; Benzaquen, Sadia; Majid, Adnan; Folch, Erik; Gorden, Jed A.; Chenna, Praveen; Chen, Alex; Abouzgheib, Wissam; Nonyane, Bareng A. S.; Yarmus, Lonny

doi:10.1016/j.athoracsur.2015.10.113

Cited by 55 publications

(49 citation statements)

References 29 publications

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“…They reported a complete resolution of air leak in 47.5% of patients and a reduction of air leak in 45% of patients. In 2016, Gilbert and colleagues [8] reported data on 75 patients who recieved intrabronchial valves for a persistent air leak. Air leak resolution occured in 56% of these patients within one day or less from intrabronchial valve placement.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of Persistent Air Leak with Endobronchial Valves

Hende¹,

Carron

2020

Advances in Respiratory Medicine

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Persistent pulmonary air leaks are usually treated conservatively with prolonged thoracostomy tube drainage. In case this approach fails, surgical revision used to be the only option. This case report describes the successful treatment of a 66-year old patient who developped a pulmonary air leak after cardiothoracic surgery that persisted despite attempted surgical repair and talc pleurodesis. The treatment was successfully completed with endobronchial valves thereby demonstrating that treatment with endobronchial valves doesn't only represent an alternative to surgery, but that it can also be successful in case surgical intervention fails.

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Section: Discussionmentioning

confidence: 99%

“…In 37% of patients, the air leak still persisted one week after valve placement. Generally, it is recommended that the valves are removed 4 to 6 weeks after placement, but in a considerable number of cases the valves were left in place without apparent significant impairment [1,4,8,9]. The number of reported adverse events is low.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Persistent Air Leak with Endobronchial Valves

Hende¹,

Carron

2020

Advances in Respiratory Medicine

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“…Endobronchiale Ventile wurden ursprünglich zur endobronchialen Lungenvolumenreduktion bei Lungenemphysem entwickelt. Inzwischen wurde eine erfolgreiche Anwendung zur Behandlung protrahierter Parenchymfisteln vielfach in der Literatur beschrieben [29,[31][32][33]. Ein entscheidender Vorteil der endobronchialen Ventile gegenüber anderen blockierenden endobronchialen Verfahren ist, dass Bronchialsekret retrograd durch das Ventil abgehustet werden kann.…”

Section: Endobronchiale Ventilimplantationunclassified

Management der postoperativ prolongierten Parenchymfistel

et al. 2018

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ZusammenfassungEine protrahierte Parenchymfistel ist eine der häufigsten postoperativen Komplikationen in der Thoraxchirurgie. Für elektive lungenresezierende Eingriffe wird in der Literatur von einer postoperativen protrahierten Parenchymfistel ab einer Dauer von 5 – 7 Tagen gesprochen. Es bestehen mehrere prädiktive Faktoren für die Ausbildung einer protrahierten Fistel, die sich in präoperative, wie beispielsweise die obstruktive Lungenerkrankung, und intraoperative Risikofaktoren, wie pleurale Adhäsionen oder fusionierte Fissuren, unterteilen lassen. Die Therapie der postoperativen protrahierten Parenchymfistel ist sehr individuell und unterscheidet sich unter Umständen je nach Patient erheblich. Es existieren 4 größere Bausteine als Therapieoptionen, die in ihrer Abfolge und Nutzung einen großen Behandlungsspielraum ermöglichen: eine intensivierte konservative Therapie, eine Installation von sklerosierenden Agenzien oder Eigenblut, endoskopische Verfahren oder eine chirurgische Revision. Die Vermeidung, Erkennung und Therapie einer postoperativen protrahierten Parenchymfistel sind alltägliche Aspekte der thoraxchirurgischen Arbeit mit hoher klinischer Relevanz. Neben einigen standardisierten Abläufen wie der Risikoidentifizierung und der diagnostischen Aufarbeitung bei einer protrahierten Fistel ist die Behandlung sehr individuell und erfordert eine große Expertise des behandelnden Chirurgen. Zu einer erfolgversprechenden, zielführenden Therapie scheint es empfehlenswert, sich innerhalb einer Klinik auf eine bestimmte standardisierte Therapieabfolge zu einigen.

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“…Of those 59 patients 33 (55%) had complete resolution of the air leak within 1 day of valve implantation. Complications were reported in two patients, and ten patients were eventually discharged home with continued chest drainage (74). IBVs have also been used to treat PAL in patients who are critically ill or being mechanically ventilated with sufficient improvement in the air leak and respiratory status that extubation and eventual ICU discharge were possible (75).…”

Section: Bronchoscopically Placed One-way Valvesmentioning

confidence: 99%

Persistent air leaks: a review with an emphasis on bronchoscopic management

Lazarus

Casal

2017

J. Thorac. Dis.

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Persistent air leak (PAL) is a cause of significant morbidity in patients who have undergone lung surgery and those with significant parenchymal lung disease suffering from a pneumothorax. Its management can be complex and challenging. Although conservative treatment with chest drain and observation is usually effective, other invasive techniques are needed when conservative treatment fails. Surgical management and medical pleurodesis have long been the usual treatments for PAL. More recently numerous bronchoscopic procedures have been introduced to treat PAL in those patients who are poor candidates for surgery or who decline surgery. These techniques include bronchoscopic use of sealants, sclerosants, and various types of implanted devices. Recently, removable one-way valves have been developed that are able to be placed bronchoscopically in the affected airways, ameliorating air-leaks in patients who are not candidates for surgery. Future comparative trials are needed to refine our understanding of the indications, effectiveness, and complications of bronchoscopic techniques for treating PAL. The following article will review the basic principles of management of PAL particularly focusing on bronchoscopic techniques.

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Use of One-Way Intrabronchial Valves in Air Leak Management After Tube Thoracostomy Drainage

Cited by 55 publications

References 29 publications

Treatment of Persistent Air Leak with Endobronchial Valves

Treatment of Persistent Air Leak with Endobronchial Valves

Management der postoperativ prolongierten Parenchymfistel

Persistent air leaks: a review with an emphasis on bronchoscopic management

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