Rescue therapy using an endobronchial valve and digital air leak monitoring in Invasive Pulmonary Aspergillosis

Tsim, Selina; Paton, Lia; Nicholson, Fiona B; Blyth, Kevin G.

doi:10.1016/j.rmcr.2014.12.001

Cited by 6 publications

(3 citation statements)

References 12 publications

(11 reference statements)

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“…The DCS allows an objective assessment of the extent of the PAL. All of the previous studies of the use of DCS have been undertaken in the United States or Europe, 1,6,[8][9][10][11][12] and to date few has been conducted in Asia.…”

Section: Commentmentioning

confidence: 99%

“…The safety and efficacy of this system for the management of PAL has been reported several times by investigators in the United States and Europe. [8][9][10][11] A recent multicenter international randomized comparison of DCS (using the Thopaz device) and ACS found that patients managed with a DCS experienced a shorter duration of chest tube placement, shorter hospital stay, and higher satisfaction scores compared with those managed with an ACS. 12) We anticipate that the popularity of DCS will increase globally, but note that few of the studies examining the potential therapeutic benefits of DCS have been conducted in Asia.…”

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confidence: 99%

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Clinical Evaluation and Outcomes of Digital Chest Drainage after Lung Resection

Fukushima

Takamori

Akamine

et al. 2016

ATCS

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Background: Analog chest drainage systems (ACS) are generally used to monitor postoperative alveolar air leakage (PAL) after lung resection. An electronic digital chest drainage system (DCS) has recently been developed that reportedly has several advantages over the traditional ACS. Here, we report a single institution's experience of PAL management with the DCS. We also sought to establish whether DCS had superior clinical benefits and outcomes compared with ACS. Methods: We enrolled 112 consecutive patients who underwent lung resection and were subsequently managed with DCS. We compared PAL rate, duration of chest drainage, and the incidence of complications with a group of 121 consecutive patients previously managed with ACS after lung resection, using propensity score matching. Results: Mean maximum and minimum PAL rates during DCS chest drainage were 48.9 ml/min (range: 2.0-868.6 ml/min) and 0.1 ml/min (0.0-1.2 ml/min), respectively. Mean PAL rate at DCS removal was 1.3 ml/min (0.0-10.0 ml/min). After propensity score matching, mean duration of chest drainage was significantly shorter with DCS than ACS (2.7 days, range: 1-9 days, compared with 3.7 days, range: 1-21 days, respectively; P = 0.031). Conclusions: Managing PAL with DCS after pulmonary resection appears to reduce the duration of chest drainage.

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Section: Commentmentioning

confidence: 99%

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confidence: 99%

Clinical Evaluation and Outcomes of Digital Chest Drainage after Lung Resection

Fukushima

Takamori

Akamine

et al. 2016

ATCS

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“…The first attempt to use EBVs for the treatment of BPF was in 2005, leading to approval as a humanitarian-use device for the treatment of BPF in 2006 [7]. EBVs are introduced through the working channel of a flexible bronchoscope utilizing a unidirectional valve to prevent airflow into the diseased area of the lung resulting in the collapse of the distal lung parenchyma and attenuation of an air leak [8]. Recently, Bermea et al [9] present the largest case series for the use of EBVs as treatment for persistent air leaks, suggesting successful removal of thoracotomy tube in eighty percent of cases with only three percent of patients with device failure.…”

Section: Discussionmentioning

confidence: 99%

Surgically intractable bronchopleural fistula treated with endobronchial valve insertion by isolating the tract with indigo carmine: A case report

Song

Kim

et al. 2020

Respiratory Medicine Case Reports

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Bronchopleural fistula (BPF) is a communication between the pleural space and the bronchial tree. Herein, we report a patient with persistent air leak after necrotizing pneumonia, where tract of BPF was not apparent in computed tomography (CT). Despite control of infection, watchful observation, repetitive procedures, and surgery, air leak was not resolved. This led to consideration of the endobronchial valve (EBV) placement. After identifying the bronchial segment leading to the fistula with indigo carmine, precise occlusion of the lingular division of the left upper lobe (LUL) was performed using an EBV. Subsequently, the air leak was resolved. During 6 months of follow-up, neither recurrence of BPF nor any procedure-related complications were noted. We concluded that precise EBV placement by identifying bronchial segment leading to the BPF, could be an effective treatment for persistent air leak.

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