Autologous blood patch pleurodesis in the management of prolonged air leak.

OBJECTIVE

Prolonged air leak is a common problem for thoracic surgeons. In this study, the efficacy of autologous blood patch pleurodesis for prolonged air leak in spontaneous pneumothorax and secondary to pulmonary hydatid cyst operations was evaluated.

METHODS

Between 1997 and 2007, autologous blood patch pleurodesis was used to treat prolonged air leak in 24 patients. Prolonged air leak was due to spontaneous pneumothorax in 17 patients and secondary to pulmonary hydatid cyst operation in 7 patients. Venous blood (2 mL/kg) was withdrawn from the patient's antecubital vein and given into the chest tube. The chest tube was unclamped and kept at 60 cm above the patient's chest. After the procedure, the tube was left in its natural position. The procedure was repeated 24 hours after the first attempt in cases of persistent air leak. The chest tube was removed after 24 hours if no air leak was observed.

RESULTS

Air leaks stopped within 24 hours in 20 patients. Four patients received an extra instillation of autologous blood of the same dose the next day. The rate of successful treatment was 87.5 %. The chest tube was removed 24 hours after termination of the air leak. No specific clinical symptoms resulting from the procedure were observed.

CONCLUSION

Management of prolonged air leak with autologous blood patch pleurodesis is a safe, easy and effective method. To our knowledge, this is the first report in the literature on the use of this method after hydatid cyst surgery.