Persistent pleuropulmonary air leak treated with autologous blood: results from a university hospital and review of literature.
BACKGROUND
Persistent air leak after pulmonary resection is a difficult complication for thoracic surgeons to manage.


OBJECTIVE
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.


CONCLUSIONS
Treating persistent pleuropulmonary air leak with autologous blood is promising, but further studies are required to quantify its real effectiveness.
Oliveira
Frederico H S
FH
Thoracic Surgery Discipline of the Surgery and Orthopedics Department, Botucatu School of Medicine, São Paulo State University, São Paulo, Brazil.
Cataneo
Daniele C
DC
Ruiz
Raul L
RL
Cataneo
Antonio J M
AJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000388:Air; D001804:Blood Transfusion, Autologous; D002648:Child; D002675:Child, Preschool; D005260:Female; D005402:Fistula / Q000601:surgery*; D006801:Humans; D008168:Lung / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000601:surgery*; D018700:Pleurodesis; D011030:Pneumothorax; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies; D055815:Young Adult