Autologous blood patch in persistent air leaks after pulmonary resection.
OBJECTIVE
Persistent air leak is among the most common complications after pulmonary resection, leading to prolonged hospitalization and increased costs. At present there is not yet a consensus on their treatment.


METHODS
During a 7-year experience, 21 patients submitted to pulmonary resection were postoperatively treated with an autologous blood patch for persistent air leaks. Persistent air leaks were catalogued twice daily according to the classification previously reported by Cerfolio and associates. Chest radiographs showed a fixed pleural space deficit in 18 (86%) patients. A total of 50 to 150 mL of autologous blood was drawn from the patient and injected into the chest tube, which was removed 48 hours after cessation of the air leak.


RESULTS
We observed a 4% incidence of persistent air leaks after pulmonary resection in our series. Persistent air leaks were categorized as follows: 14% forced expiratory, 57% expiratory, 29% continuous, and 0% inspiratory. The mean duration of prolonged air leaks was 11 days after surgery. In 81% of the cases examined, a blood patch was only carried out once and gave successful results within 24 hours. In the remaining 19% of cases, the air leak ceased within 12 hours after the second procedure. Mean hospital stay was 15 days. In our experience this procedure had a 100% success rate.


CONCLUSIONS
Pleurodesis with an autologous blood patch is well tolerated, safe, and inexpensive. This procedure is an effective technique for treatment of postoperative persistent air leaks, even in the presence of an associated fixed pleural space deficit.
Droghetti
Andrea
A
Thoracic Surgery Division, Carlo Poma Hospital, Mantova, Italy. ADroghetti@libero.it
Schiavini
Andrea
A
Muriana
Piergiorgio
P
Comel
Andrea
A
De Donno
Giuseppe
G
Beccaria
Massimiliano
M
Canneto
Barbara
B
Sturani
Carlo
C
Muriana
Giovanni
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D001691:Biological Therapy; D001804:Blood Transfusion, Autologous; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018700:Pleurodesis / Q000379:methods*; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000517:prevention & control