Bronchopleural leakage treated with fibrin sealant and high-frequency positive-pressure ventilation.
In a 62-year-old man, left spontaneous pneumothorax appeared 14 days after right pneumonectomy. The large air leakage necessitated thoracotomy and resection of a bullous area in the left upper lobe. Pleurectomy was not performed. The air leakage continued for 14 more days until, at a second left thoracotomy, numerous bullae were oversewn and covered with fibrin sealant. High-frequency positive-pressure ventilation (90 respirations/min, 21 l/min) was used for the following 6 hours. After 18 hours there was no more air leakage during spontaneous ventilation and the patient made a good recovery.
D004338:Drug Combinations / Q000627:therapeutic use; D005176:Factor XIII / Q000627:therapeutic use*; D015718:Fibrin Tissue Adhesive; D005340:Fibrinogen / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects; D011030:Pneumothorax / Q000209:etiology / Q000628:therapy*; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications / Q000628:therapy; D013917:Thrombin / Q000627:therapeutic use*; D014014:Tissue Adhesives / Q000627:therapeutic use*
D004338:Drug Combinations; D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D005340:Fibrinogen; D005176:Factor XIII; D013917:Thrombin