Predictors of prolonged air leak after pulmonary lobectomy

Prolonged air leak after video-assisted thoracic surgery lung cancer resection: risk factors and its effect on postoperative clinical recovery

“…Patients with PAL were also prone to have longer drainage time and higher incidence of postoperative complications (6)(7)(8). Therefore, those patients would have a prolonged length of stay (LOS) and increased medical costs than the…”

Mechanical Ventilation and Air Leaks After Lung Biopsy for Acute Respiratory Distress Syndrome

“…Variables with p less than 0.1 in univariate analysis were then used as independent variables in a stepwise logistic regression analysis, with a p less than 0.05 criterion for retention of variables in the final model. The multivariate procedure was validated by bootstrap bagging with 1,000 samples as has been previously described [10]. In the bootstrap procedure, repeated samples were generated with replacement from the original set of observations.…”

Surgical Management of Prolonged Air Leak in Patients with Underlying Emphysema

“…In a retrospective review on risk factors for prolonged post-operative air leak, Brunelli and associates (16) noted that patients with upper lobectomies who underwent a pleural tent had a significantly decreased duration of air leak compared to those who did not undergo a similar adjunctive procedure. Nevertheless, he later published a retrospective case matched analysis comparing patients with prolonged air leak after pulmonary resection and those without, which did not demonstrate that pleural tenting conferred any protective effect(9).…”

“…We have previously described 5 patients who underwent this technique (two COPD patients with pneumothorax refractory to conservative management, one COPD patient with prolonged air leak post lung volume reduction surgery, two patients with bronchopleural fistula/empyemas), with resolution of air leak that allows the chest tubes to be removed within 5 days after surgery and no recurrence of air leak noted at 1 year followup(129). At our institution, our indications for surgical air leak repair with flap reconstruction are (1) severe air leaks (high leak rate or continuous leak despite application of chest tube suction), (2) persistent air leak exceeding 4 weeks despite conservative management (or beyond 1 week for patients with underlying lung disease such as COPD), and (3) significant pleural dead space defined radiologically by absence of pleural-pleural contact despite maximal reexpansion efforts (16,36,130).…”

“…No universal consensus exist as to the exact duration of air leak which constitutes a prolonged air leak, but it is generally regarded to exist if it is present for more than 5 days(1-4) or 7 days(2, 5-7) after initial surgery. It is an important complication that results in increased length of stay (8)(9)(10)(11)(12)(13)(14)(15) and has been associated with other post-operative complications such as pneumonia (12,14,16), empyema (9,10,16) and ICU re-admission (12).…”