Autologous blood patch for persistent air leak in children.
OBJECTIVE
Persistent air leak (PAL) is associated with increased morbidity. Standard treatment of PAL includes chemical or mechanical pleurodesis. Long-term impact of these interventions is not known in the pediatric population. Autologous blood patch (ABP) offers a novel treatment option. We report our experience with autologous blood patch to successfully treat PAL in eight children.


METHODS
Children with PAL were treated with ABP. A fresh whole blood sample was obtained from each patient and injected via their pre-existing chest tube. Volume of blood injected, time to cessation of air leak, time to chest tube removal, outcomes and complications were reviewed.


RESULTS
Eight children aged 2 months to 18 years underwent ABP. Three children had immediate seal of air leak, while two patients sealed after 1 and 2 days. Three patients required a second ABP, after which they had immediate seal of air leak. Chest tubes were removed within 2-3 days in 7 cases. One child developed an asymptomatic pneumothorax and required 8 days for radiographic resolution.


CONCLUSIONS
ABP appears to be a safe and effective treatment option for PAL in children. ABP offers an inexpensive, easy to perform technique and avoids use of toxic chemicals for pleurodesis in pediatric patients.
Division of Pediatric Surgery, Department of Surgery, Mayo Clinic, SW, Rochester, MN 55905, USA.
Joseph B
JB
Lillegard
Raelene D
RD
Kennedy
Michael B
MB
Ishitani
Abdalla E
AE
Zarroug
Brad
B
Feltis
D000293:Adolescent; D000388:Air; D001691:Biological Therapy; D001706:Biopsy / Q000009:adverse effects; D001769:Blood; D015505:Chest Tubes / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007267:Injections; D008171:Lung Diseases / Q000150:complications / Q000601:surgery; D008297:Male; D011013:Pneumonectomy; D011030:Pneumothorax / Q000209:etiology / Q000628:therapy*; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy
ABP; Autologous blood patch; PAL; Pediatric; Persistent air leak; autologous blood patch; persistent air leak