Efficacy of an Autologous Blood Patch for Prolonged Air Leak: A Systematic Review

Hugen, Niek; Hekma, Edo J.; Claessens, Niels; Smit, Hans; Reijnen, Michel M.P.J.

doi:10.1016/j.athoracsur.2021.05.047

Cited by 14 publications

(11 citation statements)

References 27 publications

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“…Among the conservative procedures, autologous blood patch (ABP) for the treatment of PAL in patients with pneumothorax was first reported in 1987 (38). Ever since, multiple studies demonstrated its beneficial effect, with a success rate exceeding 89% (39). In our experience, this is the treatment of choice in case of unsolvable PAL after switching from water seal to one-way Heimlich valve.…”

Section: Pal Management In Robotic Thoracic Surgerymentioning

confidence: 75%

“…The procedure is simple, readily available, and cost-effective and can be reproduced in every facility: 50-250 mL (most often 100-150 mL) of peripheral venous blood drawn from the patient are instilled in the pleural cavity through the chest drain, followed by 30-45 mL of saline to keep the tube patent. Afterwards the chest tube is either clamped or, more often, suspended over a drip stand above the patient's chest level (this allows air to exit and blood to remain in the pleural cavity) (39,40). In a systematic review by Hugen et al, most reported complications of ABP were Clavien-Dindo grade I or II, like fever (most prevalent), pneumonia, empyema, or prolonged pleural effusion, with none of the patients requiring surgical treatment (39).…”

Section: Pal Management In Robotic Thoracic Surgerymentioning

confidence: 99%

“…Afterwards the chest tube is either clamped or, more often, suspended over a drip stand above the patient's chest level (this allows air to exit and blood to remain in the pleural cavity) (39,40). In a systematic review by Hugen et al, most reported complications of ABP were Clavien-Dindo grade I or II, like fever (most prevalent), pneumonia, empyema, or prolonged pleural effusion, with none of the patients requiring surgical treatment (39). A recent metaanalysis by Karampinis et al analyzed the performance of ABP for PAL after lung resection.…”

Section: Pal Management In Robotic Thoracic Surgerymentioning

confidence: 99%

See 2 more Smart Citations

Prolonged air leak after robotic lung resection: a narrative review

Muriana¹,

Rossetti²,

Viscardi³

et al. 2023

J Thorac Dis

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Background and Objective: Prolonged air leak (PAL) following lung resection is related to an increase in morbidity and both direct and indirect costs. In recent years, robotic-assisted thoracic surgery (RATS) has proved to be a safe technique with comparable perioperative outcomes of video-assisted thoracic surgery (VATS), optimal oncological results, and potential advantages in case of sublobar resection. We here focus on the incidence and clinical impact of PAL in the field of robotic surgery and discuss the therapeutic strategies currently available.Methods: We conducted a search on PubMed/MEDLINE and Scopus database from inception until May 27 th 2022 to select the relevant literature published in English exploring the occurrence of PAL following RATS.

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Section: Pal Management In Robotic Thoracic Surgerymentioning

confidence: 75%

Section: Pal Management In Robotic Thoracic Surgerymentioning

confidence: 99%

Section: Pal Management In Robotic Thoracic Surgerymentioning

confidence: 99%

See 1 more Smart Citation

Prolonged air leak after robotic lung resection: a narrative review

Muriana¹,

Rossetti²,

Viscardi³

et al. 2023

J Thorac Dis

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“…This review is limited by the small number and size of included studies, the observational nature of several studies, and study heterogeneity including but not limited to differences in underlying lung pathology (Table 1). A recent review of studies on postoperative PAL similarly found considerable heterogeneity in ABP protocols 14. Other limitations include lack of blinded outcome assessment, an unknown (and presumably sizable) proportion of patients already tolerating water seal, no stratification by baseline severity of air leak in the RCTs, and no studies investigating the impact of ABP on air leak reduction using quantitative methods.…”

Section: Discussionmentioning

confidence: 99%

Autologous Blood Patch for Persistent Air Leak Following Secondary Spontaneous Pneumothorax

Shafiq

Banka

Bain

et al. 2022

Journal of Bronchology &Amp; Interventional Pulmonology

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P ersistent air leak (PAL) complicates up to 20% to 40% of all pneumothoraces and is associated with high mortality and increased healthcare resource utilization. 1 Treatment options for PAL in cases of secondary spontaneous pneumothorax (SSP) are limited and associated with significant costs and risks. 2 Autologous blood patch (ABP) is a low-cost intervention, but its role in this population is not well-understood. We performed a systematic review of published studies examining its efficacy and safety in SSP-related PAL.

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“…Autologous blood patch may provide a simple and inexpensive treatment; 50 to 100 mL of peripheral venous blood is taken from the patient's arm and injected through the chest tube into the pleural cavity (1). A recent review shows a high rate of success of more than 89% in patients with PALs following pulmonary resection (13). Although reported complications are rare, tension pneumothorax due to thrombus obstruction in the chest tube should be noted.…”

Section: Non-surgical Management For Palmentioning

confidence: 99%

Perioperative management and surgical procedure for prolonged air leak: a clinical practice review

Ye¹,

Honda²,

Fujishima³

et al. 2023

Shanghai Chest

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The most common postoperative complication after lung resection is prolonged air leak (PAL). Although PAL is not life-threatening, it negatively affects other perioperative outcomes. Surgical management is rarely the first choice for PAL, but there are some cases that require surgical management.For fast recovery and prevention of complications, it is necessary to establish proper indications and procedures for surgical management of PAL. In this review, we attempted to describe surgical indications, preoperative detection of air leak sites and surgical treatment options for PAL. When non-surgical management is ineffective, volume and trend of air leak are major factors that need to be considered for surgical management. In the case such as with massive air leak or without trend of cure of air leaks during several days, or additional conditions such as that chemical pleurodesis was contraindicated due to pulmonary complications, early surgical management should be considered. The main concern for surgical management is the possibility of severe pleural adhesion after the first operation or pleurodesis, which makes the detection of the air leak site difficult. Recently, thoracography using fluoroscopy or computed tomography were reported to be useful to detect air leak sites before surgery. If the air leak site can be identified before surgery, unnecessary adhesiolysis can be avoided, and an access port can be easily placed to facilitate surgical manipulation. In surgical management, it may be needed not only conventional closure methods such as suturing or stapling, but also additional procedures including coverage by various sealant products or biological tissues, such as fat pad. A combination of several methods may also be necessary.

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Efficacy of an Autologous Blood Patch for Prolonged Air Leak: A Systematic Review

Cited by 14 publications

References 27 publications

Prolonged air leak after robotic lung resection: a narrative review

Prolonged air leak after robotic lung resection: a narrative review

Autologous Blood Patch for Persistent Air Leak Following Secondary Spontaneous Pneumothorax

Perioperative management and surgical procedure for prolonged air leak: a clinical practice review

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