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Background: Air leak is the most common complication after lung resection and leads to increased length of hospital (LOH) stay or patient discharge with a chest tube. Management by autologous blood patch pleurodesis (ABPP) is controversial because few studies exist, and the technique has yet to be standardized., Methods: We retrospectively reviewed patients undergoing ABPP for prolonged air leak (PAL) following lobectomy in three centers, between January 2014 and December 2019. They were divided into two groups: Group A, 120 mL of blood infused; Group B, 60 mL. Propensity score-matched (PSM) analysis was performed, and 23 patients were included in each group. Numbers and success rates of blood patch, time to cessation of air leak, time to chest tube removal, reoperation, LOH, and complications were examined. Univariate and multivariate analysis of variables associated with an increased risk of air leak was performed., Results: After the PSM, 120 mL of blood is statistically significant in reducing the number of days before chest tube removal after ABPP (2.78 vs. 4.35), LOH after ABPP (3.78 vs. 10.00), and LOH (8.78 vs. 15.17). Complications (0 vs. 4) and hours until air leak cessation (6.83 vs. 3.91, range 1-13) after ABPP were also statistically different ( p  < 0.05). Air leaks that persisted for up to 13 hours required another ABPP. No patient had re-operation or long-term complications related to pleurodesis., Conclusion: In our experience, 120 mL is the optimal amount of blood and the procedure can be repeated every 24 hours with the chest tube clamped., Competing Interests: None declared., (Thieme. All rights reserved.)

Background: Prolonged air leaks (PAL) complicate 10% to 15% of lung resections, delaying chest tube removal and prolonging length of hospital stay. No consensus exists for managing this common complication, despite favorable results for autologous blood patch pleurodesis (ABPP) in the literature. The aim of this study was to evaluate the effectiveness and safety of ABPP., Methods: We retrospectively reviewed medical records of 510 patients with PAL after lobectomy in four centers between January 2010 and December 2019. They were divided into two groups: group A consisted of patients who received ABPP for PAL of more than 5 days; and group B was patients for whom no ABPP or other procedure was performed for PAL unless strictly necessary. Propensity score matched analysis was performed, and 109 patients were included in each group. Time to cessation of air leak and chest tube removal, length of hospital stay, reoperation, and complications rate were examined., Results: After the propensity score matching, ABPP significantly reduced the number of days before chest tube removal (8.12 vs 9.30, P = .004), and length of hospital stay (10 vs 11 days, P = .045) with fewer perioperative complications (6 vs 17, P = .015). Furthermore, ABPP was related to lower incidence of any additional invasive procedures (0 vs 9, P = .002) and reoperation (0 vs 4, P = .044). No patient in the ABPP group had long-term complications related to pleurodesis., Conclusions: Autologous blood patch pleurodesis is safe and effective in reducing length of hospital stay and leads to earlier chest tube removal without increasing complications., (Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)