Autologous blood-patch pleurodesis for secondary spontaneous pneumothorax with persistent air leak

Ando, Moriaki; Yamamoto, M; Kitagawa, Chiyoe; Kumazawa, Akiko; Satō, Masaki; Shima, Koichiro; Watanabe, Atsushi; Shimokata, Keiko; Hasegawa, Yukiharu

doi:10.1053/rmed.1999.0567

Cited by 40 publications

(45 citation statements)

References 11 publications

(15 reference statements)

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“…Autologous blood-patch pleurodesis was first described by Robinson in 1987 (16) and has been used since for the treatment of primary and secondary pneumothorax (19,20). Its mechanism of action is thought to be the direct sealing of the air leak by coagulated blood as well as functioning as a true pleurodesis (17,21) and it can be employed even if the lung is not fully expanded (18).…”

Section: Discussionmentioning

confidence: 99%

“…As mentioned above, chemical pleurodesis was used in our institute as the first-line treatment of choice up to the end of 2000; however, since that time autologous blood-patch pleurodesis has replaced this procedure as the first-line treatment. Autologous blood-patch pleurodesis was performed according to the previously described method (17,20). Briefly, 50 mL of autologous blood without anticoagulant was obtained from each patient.…”

Section: Blood and Chemical Pleurodesismentioning

confidence: 99%

“…Moreover, it can contribute to the onset of acute exacerbation of idiopathic pulmonary fibrosis (14,15). As an alternative, autologous blood-patch pleurodesis has been used for the treatment of primary and secondary pneumothorax (16)(17)(18)(19)(20)(21). The injection of autologous blood into the pleural space is a simple, safe, and inexpensive treatment for pneumothorax and is available not only in patients with persistent air leak but also in those with residual air space (18).…”

Section: Introductionmentioning

confidence: 99%

“…However, since 2001, and based on previous reports (14,18,20), we have switched to using autologous blood-patch pleurodesis as first-line treatment in these patients. The aim of this study was to evaluate the efficacy and safety of autologous blood-patch pleurodesis in ILD patients.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Blood-Patch Pleurodesis for Secondary Spontaneous Pneumothorax in Interstitial Lung Disease

et al. 2011

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Objective We identified the prognostic relevance of pneumothorax in interstitial lung disease (ILD) patients and evaluated the efficacy and safety of autologous blood-patch pleurodesis. Methods We retrospectively reviewed 59 occurrences of pneumothorax in 34 ILD patients identified over a 12-year period. Results Air leakage ceased in 16 of 22 (72.7%) episodes after blood pleurodesis and in 11 of 14 (78.6%) episodes after chemical pleurodesis. Both the cure ratio and recurrence ratio in the cure episodes were comparable with those in the chemical pleurodesis group (p=0.99 and 0.99, respectively). In addition, there were no harmful events associated with blood pleurodesis. The median survival time after the first episode of pneumothorax was less than 9 months in patients with idiopathic interstitial pneumonia (IIP) and only around 3 years in the patients with other types of ILD, which have essentially favorable outcomes. Kaplan-Meier survival estimates were significantly worse in the patients with concomitant pneumomediastinum than in those without (p<0.05). A multivariate Cox regression analysis identified that the number of episodes of pneumothorax, IIP diagnosis and concomitant pneumomediastinum were independent predictors of death. Conclusion Autologous blood-patch pleurodesis is safe and worth considering as a first-line treatment for pneumothorax secondary to ILD. However, despite treatments, the prognosis after the onset of pneumothorax in ILD patients was found to be poor. In addition, concomitant pneumomediastinum may further worsen the prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Blood and Chemical Pleurodesismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy of Blood-Patch Pleurodesis for Secondary Spontaneous Pneumothorax in Interstitial Lung Disease

et al. 2011

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“…Pneumothorax associated with persistent air leakage and/or recurrence may cause serious and occasionally mortal conditions in such patients. In secondary spontaneous pneumothorax, air leakage is basically related to the presence of an underlying disease, and those who have such problems and complications are at risk during general anaesthesia or surgical treatment; therefore, an alternative treatment is required [2, 3]. …”

Section: Introductionmentioning

confidence: 99%

Diffuse Cystic Disease of the Lung Associated with Simultaneous Bilateral Spontaneous Pneumothorax: An Unknown Component of Caroli Disease?

Türüt

Gülhan²,

Gezer³

et al. 2006

Respiration

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Simultaneous bilateral spontaneous pneumothorax is an uncommon and serious medical problem frequently related to an underlying lung disease such as parenchymal lung disease, inflammatory events or neoplasms. Recurrent pneumothorax associated with persistent air leakage may pose a therapeutic dilemma in patients with underlying lung diseases. Caroli disease (CD) is a very rare congenital disorder characterised by intrahepatic biliary cystic dilatations and frequently associated with polycystic kidney and hepatic fibrosis. To date, no relation between CD and the bilateral diffuse cystic structure of pulmonary parenchyma has been described. In this paper we present a patient with the diagnosis of CD in whom simultaneous bilateral spontaneous pneumothorax was the initial finding due to severe underlying pulmonary disease. Our patient’s demographic and clinical characteristics, laboratory findings and course made us exclude the other aetiologies leading to such diffuse multi-bullous pulmonary involvement. The coincidence of recurrent pneumothorax and severe pulmonary disease has led to a big therapeutic dilemma. Open or minimally invasive surgery could be morbid or even mortal because of the nature of the parenchyma and the operative risk due to CD. Therefore, we suggest a unique conservative management including tube thoracostomy by locating the correct air spaces with the aid of high-resolution computed tomography followed by talc pleurodesis in patients with severe multi-bullous lung disease associated with potential risks due to co-morbidities.

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Instructive Cases of Pulmonary Sarcoidosis

Goodwin

Kummerfeldt

2013

Pulmonary Sarcoidosis

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Autologous blood-patch pleurodesis for secondary spontaneous pneumothorax with persistent air leak

Cited by 40 publications

References 11 publications

Efficacy of Blood-Patch Pleurodesis for Secondary Spontaneous Pneumothorax in Interstitial Lung Disease

Efficacy of Blood-Patch Pleurodesis for Secondary Spontaneous Pneumothorax in Interstitial Lung Disease

Diffuse Cystic Disease of the Lung Associated with Simultaneous Bilateral Spontaneous Pneumothorax: An Unknown Component of Caroli Disease?

Instructive Cases of Pulmonary Sarcoidosis

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