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Thorac Cardiovasc Surg 2019; 67(03): 222-226
DOI: 10.1055/s-0038-1642028
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Early Autologous Blood-Patch Pleurodesis versus Conservative Management for Treatment of Secondary Spontaneous Pneumothorax

Islam M. Ibrahim
1   Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
,
Montaser Elsawy Abd Elaziz
1   Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
,
Mohammed Ahmed El-Hag-Aly
1   Department of Cardiothoracic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
› Author Affiliations Clinical Registration Number The clinical registration number is ISRCTN75342605.
Further Information

Publication History

02 February 2018

22 February 2018

Publication Date:
19 April 2018 (online)

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Abstract

Background Autologous blood-patch pleurodesis has been effectively utilized as a treatment option for the condition of secondary spontaneous pneumothorax (SSP). Moreover, it can be used with persistent air leak, with or without residual air space. However, there have been no robust reports for the optimal timing for autologous blood-patch pleurodesis. The aim of this study is to compare early autologous blood-patch pleurodesis with conservative management of SSP.

Methods We conducted a randomized controlled study at the Menoufia University Hospital. A total of 47 patients with SSP were randomly allocated into two groups: group A (23 patients) received intrapleural instillation of 50 mL autologous blood 3 days after insertion of chest drain and group B (24 patients) managed conservatively. The duration required for air leak to seal, chest drainage duration, length of hospital stay, and the incidence of complications were compared and statistically analyzed.

Results The duration of air leak, duration to drain removal, and length of hospital stay were all significantly shorter in group A than in group B.

Conclusion Early intrapleural instillation of autologous blood is successful in sealing air leak in patients with SSP with persistent air leak, who are not fit or not willing to undergo surgery. It is superior to conservative treatment or late instillation of autologous blood, even if their lungs are not fully expanded.

Keywords

pleura - air leak - effusion - pneumothorax