Methylene Blue for Bronchopleural Fistula Localization

Sakata, Keiko; Nasim, Faria; Schiavo, Dante; Nelson, Darlene R.; Kern, Ryan; Mullon, John J.

doi:10.1097/lbr.0000000000000423

Cited by 6 publications

(9 citation statements)

References 11 publications

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“…Careful observation of dye entering the tracheobronchial tree from the affected airway establishes the diagnosis (Fig. 2) [16]. A particular advantage of this technique is that it does not require the observation of bubbling in the chest drain box as is required for accurate assessment using the sequential balloon occlusion technique [16].…”

Section: Methylene Bluementioning

confidence: 99%

“…It is then diluted with a desired volume of either normal saline or 5% dextrose in water. A potential pitfall to this approach is that administering methylene blue may not discretely localize a multifocal BPF as the dye will follow the path of least resistance, thus localizing one BPF at a time [16]. Occlusion of the initial affected segment with a balloon followed by repeating this technique may obviate this limitation.…”

Section: Methylene Bluementioning

confidence: 99%

“…Occlusion of the initial affected segment with a balloon followed by repeating this technique may obviate this limitation. Additionally, if the patient requires surgery, the dye characteristics on the organs and tissues in the pleural space may limit the surgeons' ability to easily identify mediastinal and thoracic structures [16].…”

Section: Methylene Bluementioning

confidence: 99%

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Persistent air leak - review

Sakata

Reisenauer

Kern

et al. 2018

Respiratory Medicine

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A persistent air leak (PAL) can be caused by either an alveolar-pleural fistula (APF) or bronchopleural fistula (BPF). Complications from PAL lead to an increase in morbidity and mortality, prolonged hospital stay, and higher resource utilization. Pulmonary physicians and thoracic surgeons are often tasked with the difficult and often times frustrating diagnosis and management of PALs. While most patients will improve with chest tube thoracostomy, many will fail requiring alternative bronchoscopic or surgical strategies. Herein, we review the bronchoscopic and surgical diagnostic and treatment options for PAL as it pertains to the field of interventional pulmonology and thoracic surgery.

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Section: Methylene Bluementioning

confidence: 99%

Section: Methylene Bluementioning

confidence: 99%

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Persistent air leak - review

Sakata

Reisenauer

Kern

et al. 2018

Respiratory Medicine

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“…In 2013, van Zeller and colleagues described the technique whereby, under sedation, one clinician injects intrapleural methylene blue and another clinician simultaneously inspects the bronchi with a bronchoscope for appearance of intrabronchial methylene blue (30). The technique has also been replicated by Sakata and colleagues (31). In 2014, Jin et al reported the successful localization of the culprit segments or subsegments in all 27 patients enrolled by instilling methylene blue via the working channel of the bronchoscope.…”

Section: Methylene Blue Instillationmentioning

confidence: 99%

Evaluation and endoscopic management of persistent air leaks

Secasanu¹,

Keshishyan²,

Revelo³

2020

Shanghai Chest

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The endoscopic management of persistent or prolonged air leak (PAL) has gained popularity, not only in post-surgical PAL but also in non-surgical scenarios. The literature that supports an endoscopic approach is restricted to case series, case reports, retrospective and some small prospective studies. Every patient who suffers from PAL secondary to bronchopleural fistula (BPF) or alveolopleural fistula (APF) should always be evaluated to determine surgical repair candidacy. There have been a number of articles that summarize the bronchoscopic modalities for the management of PAL, but none emphasize the initial evaluation with an algorithmic approach or discuss how to follow-up these patients in the immediate posttreatment phase and long-term. Medical causes of PAL are, in our opinion, more difficult to localize and consequently treat compared to surgical causes of air leak. The bronchoscopic management for either surgical or non-surgical BPF's is similar. In this review, we discuss the initial evaluation, management and follow up with an algorithmic approach of PAL as well as review the available endoscopic modalities.

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“…Alternatively, retrograde instillation of methylene blue through the chest drain while under bronchoscopy observation has also proven to be a viable approach. 11 The diagnosis is confirmed when the dye is observed to enter the tracheobronchial tree from the diseased airway. This procedure is easy and inexpensive, making it a feasible alternative to serial balloon occlusion.…”

Section: Introductionmentioning

confidence: 97%

Bronchoscopic interventions for bronchopleural fistulas

Jin

2023

Ther Adv Respir Dis

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Bronchopleural fistula is a potentially fatal disease most often caused after pneumonectomy. Concomitant problems such as pulmonary infection and respiratory failure are typically the main contributors to patient mortality because of the improper contact between the bronchial and pleural cavity. Therefore, bronchopleural fistulas need immediate treatment, which requires the accurate location and timely closure of the fistula. Currently, bronchoscopic interventions, because of their flexibility and versatility, are reliable alternative therapies in patients for whom surgical intervention is unsuitable. Possible interventions include bronchoscopic placement of blocking agents, atrial septal defect (ASD)/ventricular septal defect (VSD) occluders, airway stents, endobronchial valves (EBVs) and endobronchial Watanabe spigots (EWSs). Recent developments in mesenchymal stem cells (MSCs) transplantation technology and three-dimensional (3D) printed stents have also contributed to the treatment of bronchopleural fistula, but more research is needed to investigate the long-term benefits. This review focuses on the effectiveness of various bronchoscopic measures for the treatment of bronchopleural fistula and the directions for future development.

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Methylene Blue for Bronchopleural Fistula Localization

Cited by 6 publications

References 11 publications

Persistent air leak - review

Persistent air leak - review

Evaluation and endoscopic management of persistent air leaks

Bronchoscopic interventions for bronchopleural fistulas

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