For patients who are not surgical candidates or who have had a failure of surgical management, pleurodesis with a variety of substances is. Autologous blood patch pleurodesis is a safe, effective, and easily performed procedure with no need of any additional equipment or extra cost. The aim of the present study was to evaluate the efficacy of autologous blood pleurodesis in the management of persistent air leak in spontaneous pneumothorax. Autologous blood patch pleurodesis abpp has superior outcomes for persistent air leak pal in terms of sealing time, success rate, and complication rate. Outside the vascular system, blood is known to be related to adhesion formation and. A good choice in patients with persistent air leak. Autologous blood injection abi involves injecting a patients blood into a damaged part of the body. Autologous blood patch pleurodesis is known to reduce the recurrence rate in ssp patients 8, 9, and has success rates of 73100% on single admission for prolonged air leak 2, 4, 7, 12. Robinson 1 first described autologous blood patch pleurodesis in 1987. We report a bedside interventional bronchoscopy technique using a swanganz catheter for the treatment of pals while intubated and ventilated. Clot and fibrogenic activity of blood create pleurodesis via pleural irritation and inflammation, but tetracycline and talc create a quicker pleurodesis via direct pleural inflammation without patch effect. Autologous blood pleurodesis could involve two factors working together. How to perform an autologous blood patch pleurodesis in a.
A success rate of 27 % was observed having the air leak sealed in 4. Tension pneumothorax complicating autologous blood patch. Abstract objective to describe the clinical course, outcome and success rate of 8 dogs with persistent pneumothorax treated with autologous blood. Autologous blood, although free of toxicity, produced only histologic evidence of pleurodesis potential at 1 month angiogenesis at the pleural surface. However, when pneumothorax is resistant to pleurodesis, no other procedure is more effective and conservative. There are numerous chemical agents fibrin glue, erythromycin, ok432, tetracycline, 50% glucose solution, autologous blood patch and talc slurry, etc. Pneumothorax associated with chronic graftversushost disease cgvhd after stem cell transplantation is a rare complication. Although the mechanism of autologous blood pleurodesis is not clear, dumire et al. Robinson 14 was the first in 1987 to report an 85% success rate with this technique in chronic or recurrent spontaneous pneumothoraces. However, despite treatments, the prognosis after the onset of pneumothorax in ild patients was found to be poor. This study investigates the feasibility, effectiveness, clinical outcomes, and economical benefits of the autologous blood patch pleurodesis method in ssp. The effectiveness of blood amount used in pleurodesis to. Some case series have reported success with autologous blood patch for persistent air leaks in pneumothoraces or for pleurodesis 911, a process of injecting the patients own blood into the pleural space through a chest tube. Pleurodesis by autologous blood pab is an effective, simple and inexpensive method in a select number of cases of oncological pulmonary surgery.
He treated 25 patients with chronic spontaneous pneumothorax and reported. Autologous blood patch pleurodesis in spontaneous pneumothorax with persistent air. A prospective study of autologous blood patch pleurodesis for persistent air leak after pulmonary resection. Nevertheless, according to some authors blood can also act like a sclerotic agent causing a few adhesions 3. In the first study carried on autologous blood patch pleurodesis for the treatment of persistent air leak in patients with spontaneous pneumothorax, robinson et al5 1987 took 25 patients. Efficacy and safety profile of autologous blood versus. As soon as the blood was drawn from the patient, it was injected through a povidoneiodine betadineprepared portion of the rubber connecting tube that was attached to the posterior chest tube.
Does medical ozone increase the pleurodesis effectiveness. On the other hand it should be noted that intrapleural talc administration can lead to severe side effects. The duration of the air leak exceeded 7 days in all patients. All patients operated on by a single surgeon between january 2002 and january 2004 and presenting with a persistent air leak after pulmonary resection have been treated by the autologous blood patch. Prolonged air leak and recurrence prevention using tetracycline via chest drain n726 is likely to provide recurrence rates between. Effectiveness of chemical pleurodesis in spontaneous. However, there are few case reports of successful treatment of ppc with.
Successful treatment of pleuroperitoneal communication. Aside from supportive care, the literature includes anecdotal successful reports using fibrin sealants, ethanol injection, metal coils, and watanabe spigots. The efficacy and economical benefits of blood patch pleurodesis in. Autologous blood patch pleurodesis abpp has superior outcomes for persistent air leak pal in terms of sealing time, success rate, and complication rate when compared with conservative treatment. A number of 15 patients 10 male and 5 female were included in this prospective study between march 2005 and december 2009. In this vetgirl online veterinary continuing education blog, we demonstrate how to perform an autologous blood patch pleurodesis for treatment of pneumothorax in a dog. Retrospective evaluation of the use of autologous blood. Blood pleurodesis has been used for primary and secondary pneumothorax,1 7 persistent postoperative air leak8 11 and hydrothorax complicating peritoneal dialysis. Autologous blood patch pleurodesis has been reported in the literature by many authors as a procedure for pal and pneumothorax with encouraging results. Considering the window of recurrence after pneumothoraces, it is doubtful that autologous blood has a role in this treatment setting with the information currently at hand. Reports recommend the use of 50200 ml in adults, but there are no studies specifically evaluating this issue. In the present case, both left pneumothorax and pleural effusion were detected.
Autologous blood pleurodesis was applied to these patients after a sevenday time limit. Pleurodesis has been performed by infusion of talc, bacterial components ok432, antibiotics tetracycline, doxycycline, and anticancer agents mitomycin, adriamycin with a success rate ranging from 60% to 94%. To evaluate the efficacy and risks of autologous blood patch pleurodesis in patients with persistent air leak after pulmonary resection. The blockage of a small air leak by forming a clot and the fibrogenic activity of the blood in the pleural cavity producing inflammation and irritation of both pleurae. Although highly effective, the autologous blood patch pleurodesis technique. To our knowledge, this is the first report in the literature on the use of this. The management of chemical pleurodesis with viscum album. However, the ideal management strategy remains undetermined. A good choice in patients with persistent air leak ufuk cobanoglu 1, mehmet melek 2, yesim edirne 2 1 department of chest surgery. Autologous blood patch injection abi what is an autologous blood patch injection. Pleural blood patching reduces the rate of chest tube placement for.
Pleurodesis with an autologous blood patch to prevent. Pleurodesis by autologous blood, doxycycline, and talc in. A persistent pulmonary air leak is an infrequent problem that occurs as a result of pulmonary surgery and as a result of traumatic and spontaneous pneumothorax. Intrapleural instillation of autologous blood fine. A blood patch pleurodesis was accomplished on the ward using 50 ml of autologous blood. Autologous blood patch pleurodesis has been first reported by robinson et al. Conclusion autologous bloodpatch pleurodesis is safe and worth considering as a firstline treatment for pneumothorax secondary to ild. An autologous blood patch pleurodesis is, in our limited experience, a simple, painless, inexpensive, and effective treatment for patients with a persistent pulmonary air leak. Pleurodesis is principally aimed at the palliation of malignant pleural effusions or recurrent pneumothorax. The patients were divided into two groups as receiving 60 ml and 120 ml autologous blood patch pleurodesis in group 1 n20 and group 2 n22, respectively. In the remaining 19% of cases, the air leak ceased within 12 hours after the second procedure. We have obtained a 100% success rate in 11 patients with persistent air.
Autologous blood has been used successfully for pleurodesis, which was less toxic than chemical agents. Table 1 success of blood pleurodesis in the setting of persistent air leak. Blood pleurodesis for the medical management of pneumothorax. Hence talc was selected to arrest air leakage and prevent recurrent pleural effusion following failed pleurodesis with autologous blood. Pleurodesis is an excellent method used to treat air leak and it is feasible by means of surgery, autologous blood and several intrapleural chemical agents such as talc powder, tetracycline, doxycycline, bleomycine ect. Use of autologous blood patch for prolonged air leak in. Additionally, given the simple, inexpensive, and painless nature of this bedside surgical procedure, abpp should be considered for pal.
A case is reported here of bloodpatch pleurodesis for pneumothorax in lung fibrosis due to pss. Use of autologous blood patch pleurodesis has been first reported by robinson et al 1987 for the treatment of pal in patients with spontaneous pneumothorax with a success rate of 85% in a series of 25 patients 3. Autologous blood irritates the pleural surfaces and is considered to act by formatting a patch of clotted blood fibrin, which can potentially adhere to the lung parenchyma that produces the leak. Pleural blood patching reduces the rate of chest tube placement for postbiopsy pneumothorax. Management of prolonged air leak with autologous blood patch pleurodesis is a safe, easy and effective method. Some reports have stated that the success rate of abp pleurodesis correlates with air. Autologous blood patch in persistent air leaks after.
Pleural adhesion with autologous blood is advantageous, since it is safe and has almost no adverse effects. Autologous blood for pleurodesis in recurrent and chronic spontaneous pneumothorax. Prolonged air leak in secondary spontaneous pneumothorax ssp patients remains one of the biggest challenges for thoracic surgeons. Following a recent randomised controlled trial rct of intrapleural instillation of autologous blood in the treatment of prolonged air leak. Intrapleural instillation of autologous blood for persistent air leak in. A success rate of 27% was observed having the air leak sealed in 4. Ufuk cobanoglu 1, mehmet melek 2, yesim edirne 2 1 department of chest surgery, university of yuzuncu yil, turkey 2 department of pediatric surgery, university of yuzuncu yil, turkey. This study investigates the feasibility, effectiveness, clinical outcomes, and economical benefits of the autologous blood patch pleurodesis method. Autologous blood patching has been described as a simple, inexpensive, and safe treatment for persistent air leak from secondary pneumothorax 2 4, 7 and following surgery, 2, 5 with success rates ranging from 59% to 100% in published series. Platelets are tiny cells in blood, which stick to each other when we cut. Autologous blood patch pleurodesis has been studied extensively in adults, and some authors propose it as the gold standard for treatment because it is cheap, quick and safe. Pleurodesis with an autologous blood patch to treat a persistent air leak after pneumothorax was first reported by robinson, 8 x 8 robinson, c.
Success is also reported with chemical and autologous blood patch pleurodesis 1. Firstly, the formation of a clot blood patch effect and subsequently induced pleural irritation and inflammation, leading to the formation of pleural adhesions fibrinous pleuritis. While pneumothorax is often treated by thorocentesis, chest tube placement, or rarely, surgical correction, the use of an autologous blood patch can be considered for those that have failed conservative therapy or. Study protocol open access intrapleural instillation of. The application of blood pleurodesis was used as the last.
Pleurodesis with an autologous blood patch is well tolerated. He reported a 85% success rate in a series of 25 patients who received injections of 50ml of blood in order to seal the air leak 6. However, there is a need for optimising the approach to autologous blood patch and establishing its efficacy and safety in controlled trials. Over time, there have been many published studies comparing 12 mlkg of autologous blood. Hemoptysis following talc pleurodesis in a pneumothorax. Autologous blood patch for persistent air leak in pneumothorax is efficacious, readily available, cheap and well tolerated. Blood contains many nutrients and substances which are thought to promote healing. Intrapleural instillation of autologous blood finetuning techniques for better success rate. The efficacy and economical benefits of blood patch. Only one controlled study exists, in which the recurrence rate was improved from 16% in controls to 0% in the blood pleurodesis group at 1248 months, the duration of tube drainage was reduced and the procedure was successful in 84%. In our experience this procedure had a 100% success rate. Autologous blood patch pleurodesis is a safe, effective, and easily.