title: Blood patch for persistent air leak:  a review of the current literature.
abstract: OBJECTIVE
  Persistent air leak (PAL) poses a significant challenge to the thoracic surgeon. Of the numerous methods employed to manage this problem, autologous blood 'patch' pleurodesis (ABPP) remains one of the most controversial, seemingly due to a lack of robust data and consensus of opinion regarding its efficacy, technique of application and its role in clinical practice. Despite a lack of randomized control trials, the evidence to-date has shown ABPP to be an efficacious, cheap, simple, well tolerated and readily available treatment, with minimal side effects and broad range of applications, allowing for earlier chest drain removal, decreased complications and decreased hospital stay. A review is therefore required to assess the role for ABPP in contemporary clinical practice.
  
  
  RESULTS
  Recent studies have demonstrated that ABPP is an effective management for PAL in specific patient groups and there is an argument that it has the potential to be the gold-standard or first-line treatment in certain clinical scenarios such as for patients with interstitial lung disease or acute respiratory distress syndrome.
  
  
  CONCLUSIONS
  This review aims to discuss the relevance of recent findings and to suggest a firm role for ABPP in current practice. In addition, the evidence for the efficacy of ABPP will be assessed and compared with other established methods of pleurodesis. Finally, the review will include a summary of relevant research to-date in order to suggest an evidence-based standardized protocol for the application of ABPP.
authors.affiliation: Department of Thoracic Surgery, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Manley
authors.forename: Aman
authors.initials: A
authors.lastname: Coonar
authors.forename: Frank
authors.initials: F
authors.lastname: Wells
authors.forename: Marco
authors.initials: M
authors.lastname: Scarci
mesh_terms: D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000379:methods*; D015505:Chest Tubes / Q000009:adverse effects; D004322:Drainage / Q000009:adverse effects; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000628:therapy*; D018700:Pleurodesis / Q000009:adverse effects / Q000379:methods*; D011030:Pneumothorax / Q000628:therapy*; D012128:Respiratory Distress Syndrome / Q000628:therapy*