287 results on '"Persistent air leak"'
Search Results
152. Management of residual pleural space and persistent airleak after major lung resection
- Author
-
Stamatios Kakaris, Nikolaos A. Papakonstantinou, Kalliopi Athanassiadi, and Ioannis Alevizakis
- Subjects
Leak ,medicine.medical_specialty ,business.industry ,Retrospective cohort study ,Surgery ,Catheter ,Bilobectomy ,Anesthesia ,medicine ,Persistent air leak ,Lung surgery ,Lung resection ,Complication ,business - Abstract
OBJECTIVE: Residual space and persistent air leak is the most common complication after lung resection, requiring additional treatment and hospital stay. The aim of this retrospective study is to assess the role of an anteriorly placed Pezzer catheter in order to treat prolonged alveolar air leakage and apical residual space after lung surgery. MATERIAL: During the last 7 years, out of 853 patients submitted to upper lobectomy/ bilobectomy for NSCLC, Lung Volume Reduction (LVR) for emphysema or reoperation, 79 (9.2%) experienced pleural space problems associated with prolonged air leak (>7days). Patients were divided into 2 groups: (A) with anterior Petzer catheter (n=52) and (B) (n=27) treated with reoperation or Heimlich valve, according to the surgeon9s preference. Duration of drainage, length of hospital stay and the need of additional interventions to treat the persistent postoperative alveolar leak were compared. RESULTS: No differences were found in the 2 groups concerning age, gender, type of resection, location (left/right). A significant reduction of the duration of drainage and of the length of the postoperative in-hospital stay was found in Group A compared to Group B. Obliteration of the pleural space was observed in all cases of Group A in a mean time of 2 days (range 1 to 4 days, while 4 patients of Group B were discharged with a residual pleural space. CONCLUSIONS: Our experience supports the use of an anterior Petzer catheter connected to water seal, whenever a space problem associated with prolonged air leak occurs. It reduces significantly the duration of the intrapleural drainages and the length of the in-hospital stay. The procedure is effective, safe, and easy to perform.
- Published
- 2016
153. Pneumothorax in cystic fibrosis: beyond the guidelines
- Author
-
Andrew Jones, A. Kevin Webb, Peter J. Barry, and RW Lord
- Subjects
Pulmonary and Respiratory Medicine ,Diagnostic Imaging ,Male ,medicine.medical_specialty ,Adolescent ,Cystic Fibrosis ,medicine.medical_treatment ,Cystic fibrosis ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Significant risk ,Intensive care medicine ,Lung function ,business.industry ,Disease Management ,Pneumothorax ,medicine.disease ,Prognosis ,Respiratory Function Tests ,030228 respiratory system ,Pediatrics, Perinatology and Child Health ,Persistent air leak ,Complication ,business ,Pleurodesis - Abstract
Pneumothorax is a serious but common complication in patients with cystic fibrosis (CF). It has adverse prognostic implications as well as associations with subsequent reduction in lung function and significant risk of recurrence. Management dilemmas frequently occur that are beyond current guidelines. We review the evidence and highlight management difficulties in pneumothoraces in CF.
- Published
- 2016
154. Blood patch for persistent air leak
- Author
-
Marco Scarci, Kate Manley, Aman S. Coonar, and Frank Wells
- Subjects
Pulmonary and Respiratory Medicine ,Respiratory Distress Syndrome ,medicine.medical_specialty ,Blood transfusion ,Thoracic surgeon ,business.industry ,medicine.medical_treatment ,Autologous blood ,Pneumothorax ,Air leak ,Surgery ,Blood Transfusion, Autologous ,Chest Tubes ,Drainage ,Humans ,Persistent air leak ,Medicine ,Current (fluid) ,Lung Diseases, Interstitial ,business ,Pleurodesis - Abstract
Persistent air leak (PAL) poses a significant challenge to the thoracic surgeon. Of the numerous methods employed to manage this problem, autologous blood 'patch' pleurodesis (ABPP) remains one of the most controversial, seemingly due to a lack of robust data and consensus of opinion regarding its efficacy, technique of application and its role in clinical practice. Despite a lack of randomized control trials, the evidence to-date has shown ABPP to be an efficacious, cheap, simple, well tolerated and readily available treatment, with minimal side effects and broad range of applications, allowing for earlier chest drain removal, decreased complications and decreased hospital stay. A review is therefore required to assess the role for ABPP in contemporary clinical practice.Recent studies have demonstrated that ABPP is an effective management for PAL in specific patient groups and there is an argument that it has the potential to be the gold-standard or first-line treatment in certain clinical scenarios such as for patients with interstitial lung disease or acute respiratory distress syndrome.This review aims to discuss the relevance of recent findings and to suggest a firm role for ABPP in current practice. In addition, the evidence for the efficacy of ABPP will be assessed and compared with other established methods of pleurodesis. Finally, the review will include a summary of relevant research to-date in order to suggest an evidence-based standardized protocol for the application of ABPP.
- Published
- 2012
155. Endoscopic Cyanoacrylate for Persistent Air Leak From a Bronchopleural Fistula in a Patient With Idiopathic Pulmonary Fibrosis
- Author
-
Vicente Roig Figueroa and Blanca de Vega Sánchez
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Fistula ,Bronchopleural fistula ,General Medicine ,030204 cardiovascular system & hematology ,medicine.disease ,Bronchial Fistula ,Surgery ,Endoscopy ,law.invention ,03 medical and health sciences ,Idiopathic pulmonary fibrosis ,0302 clinical medicine ,030228 respiratory system ,Cyanoacrylate ,law ,medicine ,Persistent air leak ,Radiology ,business - Published
- 2017
156. Blood-patch pleurodesis for pneumothorax in lung fibrosis due to progressive systemic sclerosis: A case report
- Author
-
Koichi Kurishima, Toshihiro Shiozawa, Katsunori Kagohashi, Nobuyuki Hizawa, Kunihiko Miyazaki, Tomohiro Tamura, Hiroaki Satoh, and Gen Ohara
- Subjects
Cancer Research ,medicine.medical_specialty ,pneumothorax ,medicine.medical_treatment ,Immunology and Microbiology (miscellaneous) ,blood-patch pleurodesis ,medicine ,In patient ,progressive systemic sclerosis ,business.industry ,lung fibrosis ,Lung fibrosis ,Progressive systemic sclerosis ,Treatment options ,Articles ,General Medicine ,respiratory system ,medicine.disease ,respiratory tract diseases ,Surgery ,surgical procedures, operative ,Pneumothorax ,Persistent air leak ,Air space ,business ,Pleurodesis - Abstract
Pneumothorax in patients with progressive systemic sclerosis (PSS) often presents as a difficult-to-treat disease. Autologous blood-patch pleurodesis has previously been used for the treatment of pneumothorax. Blood outside its own environment is an irritant; therefore, chest physicians must watch closely for an allergic reaction. The injection is simple, painless, causes no side effects, is an inexpensive treatment for pneumothorax and is available not only in patients with persistent air leak but also in those with residual air space. A case is reported here of blood-patch pleurodesis for pneumothorax in lung fibrosis due to PSS. As an alternative therapy for difficult-to-treat pneumothorax in patients with PSS with persistent air leak and residual air space, autologous blood-patch pleurodesis would be one of the treatment options.
- Published
- 2014
157. Role of the IBV Valve in Persistent Air Leak
- Author
-
Salim Surani, S. Surani, Joseph Varon, and Shweta Rao
- Subjects
Pulmonary and Respiratory Medicine ,business.industry ,Anesthesia ,Persistent air leak ,Medicine ,business - Published
- 2014
158. Is blood pleurodesis effective for determining the cessation of persistent air leak?
- Author
-
Andrea Bille, Anthony J. Chambers, Marco Scarci, and Tom Routledge
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Pleural effusion ,medicine.medical_treatment ,Pulmonary air leakage ,Recurrence risk ,Postoperative Complications ,medicine ,Humans ,RESPIRATORY DISTRESS SYNDROME ADULT ,Pneumonectomy ,Pleurodesis ,business.industry ,Air ,Pneumothorax ,medicine.disease ,Surgery ,Conservative treatment ,Blood ,Anesthesia ,Persistent air leak ,Cardiology and Cardiovascular Medicine ,business - Abstract
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed whether blood pleurodesis is effective for cessation of persistent air leak (PAL). Altogether more than 43 papers were found using the reported search, of which 10 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that autologous blood pleurodesis has superior outcomes when compared with conservative management for treatment of postoperative PAL. In addition, for PAL causing pneumothorax, blood pleurodesis [optimal volume 100 ml (from two studies)] should be considered in patients who are unsuitable for surgery, talc pleurodesis is ineffective or not viable (including cases complicated by acute respiratory distress syndrome) and a prompt resolution is required. Some 70-81% of patients treated for postoperative air leak resolved within 12 h and 95-100% within 48 h vs. a mean of 3-6.3 days (from two studies) with simple drainage. Resolution of pneumothorax with blood pleurodesis was also significantly shorter (P0.01). Overall success rates (from all studies) were 92.7% (n=133) from patients having undergone pulmonary surgery (76.6% in one injection, n=111), and 91.7% (n=109) of patients with pneumothorax. Recurrence rates were between 0 and 29% compared with 35-41% for simple drainage, although one controlled study in which the recurrence rate was improved from 16% in controls to 0% in the blood pleurodesis group (at 12-48 months). Minor complication (empyema/fever/pleural effusion) rates varied between studies (0-18%), although they show reduced incidence in line with improving technique over time. A controlled study looking at acute respiratory distress syndrome complicated by pneumothorax showed a significant reduction in mortality (odds ratio 0.6), time to cessation of air leak (P0.01), weaning time (P0.01) and intensive treatment unit (ITU) stay (P0.01) whilst another randomized control study showed significant reduction in hospital stay following pulmonary resection (P0.001).
- Published
- 2010
159. Persistent air leak successfully treated with endobronchial valves and digital drainage system
- Author
-
Phan Nguyen, Thomas James Altree, and Hubertus Jersmann
- Subjects
Pulmonary and Respiratory Medicine ,Suction (medicine) ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Endobronchial valve ,030204 cardiovascular system & hematology ,medicine.disease ,Severe chronic obstructive pulmonary disease ,respiratory tract diseases ,Surgery ,03 medical and health sciences ,Catheter ,0302 clinical medicine ,030228 respiratory system ,Pneumothorax ,Bronchoscopy ,medicine ,Persistent air leak ,medicine.symptom ,business ,Subcutaneous emphysema - Abstract
A 62-year old man with severe chronic obstructive pulmonary disease developed a persistent air leak from an iatrogenic pneumothorax following Computed Tomography-guided core biopsy of a pulmonary nodule. The pneumothorax was treated with an 8.5F intercostal catheter, which was then replaced by a 28F thoracostomy tube after development of significant subcutaneous emphysema and a tension pneumothorax. The air leak showed no improvement until endobronchial valve (EBV) insertion guided by objective flow data from a digital drainage system (DDS). The air leak subsequently reduced with -20 cmH2O suction from the DDS, and the thoracostomy tube was removed once the objective measured flow rate had sufficiently diminished. The combination of EBV insertion and suction from the DDS successfully treated the persistent air leak, with timing of thoracostomy tube removal guided by DDS flow data.
- Published
- 2018
160. Minimally invasive persistent air leak management
- Author
-
Jonathan S. Kurman and D. Kyle Hogarth
- Subjects
medicine.medical_specialty ,business.industry ,Treatment options ,General Medicine ,humanities ,Therapeutic modalities ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Medicine ,Persistent air leak ,In patient ,030212 general & internal medicine ,business ,Intensive care medicine - Abstract
Persistent air leak (PAL) management is a complex clinical entity with a variety of underlying etiologies and treatment options. Imprecise use of nomenclature associated with this condition has confounded the situation. Guidelines on the subject are antiquated and do not include modern therapeutic modalities. Bronchoscopic options, namely endobronchial valves, have revolutionized PAL treatment in patients who are poor surgical candidates. The paucity of high-quality data has prohibited revision of older guidelines. Development of evidence-based treatment algorithms is necessary to advance the quality and consistency of care for this serious clinical problem.
- Published
- 2018
161. Autologous blood pleurodesis: A good choice in patients with persistent air leak
- Author
-
Ufuk Çobanoğlu, Mehmet Melek, and Yesim Edirne
- Subjects
Pulmonary and Respiratory Medicine ,Thorax ,pleurodesis ,medicine.medical_specialty ,Leak ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_treatment ,Talc ,Pulmonary function testing ,Medicine ,Prospective cohort study ,lcsh:RC705-779 ,business.industry ,Autologous blood ,persistent air leak ,lcsh:Diseases of the respiratory system ,medicine.disease ,Surgery ,Chest tube ,Pneumothorax ,lcsh:RC666-701 ,Anesthesia ,Original Article ,Cardiology and Cardiovascular Medicine ,business ,Pleurodesis ,medicine.drug - Abstract
Aim: The study compares the efficiency, side effects and complications of autologous blood pleurodesis with talcum powder and tetracycline. Materials and Methods: This prospective study evaluated 50 patients with persistent air leak resulting from primary and secssondary spontaneous pneumothorax between February 2004 and March 2009. The patients inclussded 32 (64.0%) males and 18 (36.0%) females with a median age of 39 years (range 14-69 years). All cases had persistent air leak of more than seven days. Pleurodesis was performed using autologous blood in 20 (40.0%) patients, talc powder in 19 (38.0%) patients and tetracycline in 11 (22.0%) patients through a chest tube. Air leak cessation times after pleurodesis, side effects and pulmonary function tests (PFT) in the first and third months were measured. Results: Recurrent primary spontaneous pneumothorax was the cause of persistent air leak in all cases. Air leaks were expiratory only in 54.0% of cases. We obtained a success rate of 75.0% using autologous blood, 84.2% using talc powder and 63.6% using tetracycline. Mean air leak termination interval was significantly (P < 0.001) shorter in patients treated with autologous blood in comparison to talc powder and tetracycline. We observed a significant (P < 0.05) decline in PFT in patients treated with talc powder compared with tetracycline and autologous blood. Vital capacity, FVC and FEV1 were significantly lower in patients treated with tetracycline compared with autologous blood. Conclusion: This study shows that autologous blood pleurodesis compared to talc powder and tetracycline is related with shorter leak cessation time and less pulmonary function decline in patients with persistent air leak. We think further randomized clinical trials of pleurodesis as treatment could increase its use in thorax surgery by demonstrating the safety and the efficacy of this procedure.
- Published
- 2009
162. Guidelines for the Diagnosis and Treatment of Spontaneous Pneumothorax
- Author
-
Juan José Rivas de Andrés, Marcelo F. Jiménez López, Juan Torres Lanzas, Laureano Molins López-Rodó, and Alfonso Pérez Trullén
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Pneumothorax ,Catamenial pneumothorax ,Treatment options ,Tube drainage ,General Medicine ,respiratory system ,medicine.disease ,respiratory tract diseases ,Surgery ,Pulmonology ,Cardiothoracic surgery ,Internal medicine ,medicine ,Humans ,Persistent air leak ,Secondary spontaneous pneumothorax ,business ,Algorithms - Abstract
This is the fourth update of the guidelines for the diagnosis and treatment of pneumothorax published by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). Spontaneous pneumothorax, or the presence of air in the pleural space not caused by injury or medical intervention, is a significant clinical problem. We propose a method for classifying cases into 3 categories: partial, complete, and complete with total lung collapse. This classification, together with a clinical assessment, would provide sufficient information to enable physicians to decide on an approach to treatment. This update introduces simple aspiration in an outpatient setting as a treatment option that has yielded results comparable to conventional drainage in the management of uncomplicated primary spontaneous pneumothorax; this technique is not, as yet, widely used in Spain. For the definitive treatment of primary spontaneous pneumothorax, the technique most often used by thoracic surgeons is video-assisted thoracoscopic bullectomy and pleural abrasion. Hospitalization and conventional tube drainage is recommended for the treatment of secondary spontaneous pneumothorax. This update also has a new section on catamenial pneumothorax, a condition that is probably underdiagnosed. The definitive treatment for a recurring or persistent air leak is usually surgery or the application of talc through the drainage tube when surgery is contraindicated. Our aim in proposing algorithms for the management of pneumothorax in these guidelines was to provide a useful tool for clinicians involved in the diagnosis and treatment of this disease.
- Published
- 2008
163. Intrabronchial valves for persistent pulmonary air leaks in children.
- Author
-
Qureshi, Faisal G., Abdelrahman, Ahmed, Baig, Mirza Zain, Megison, Stephen, and Abu-Hijleh, Muhanned
- Subjects
PULMONARY valve ,PNEUMONECTOMY ,SURGICAL complications ,AIR flow ,AIR ,LUNG diseases - Abstract
Surgery to address parenchymal lung disease in children is rare. One of the complications of the surgery is a persistent air leak (PAL). Intrabronchial valves (IBV), which received FDA approval for treating PAL in recent years, limit or exclude the inflow of air towards the pleura and allow air and secretions to flow towards central airways. The valves have been effective in adults with PAL but little has been published on their use in children. Retrospective chart review was performed after IRB approval on patients treated with IBV after surgical excision of lung parenchyma. A literature review was then performed. 2 pediatric patients are presented. Patient 1, a 10 year old girl underwent excision of a lung mass that developed persistent air leak. Traditional conservative methods did not seal the air leak for 23 days but an IBV sealed the leak in 24 h. Patient 2, a 6 year old boy underwent a pneumonectomy with post-operative bronhical leak. The bronchus was repaired but a leak persisted for 36 days. An IBV sealed the leak immediately. Intrabronchial valves can be used for the management of persistent pulmonary air leaks. We propose a tentative algorithm for using the devices in children with PAL. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
164. Risk Factors and Epidemiology of Coccidioidomycosis Demonstrated by a Case of Spontaneous Pulmonary Rupture of Cavitary Coccidioidomycosis
- Author
-
Amy A. Yau
- Subjects
medicine.medical_specialty ,business.industry ,medicine.drug_class ,Radiography ,Antibiotics ,Case Report ,General Medicine ,medicine.disease ,Thoracostomy ,Surgery ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Pneumonia ,0302 clinical medicine ,030228 respiratory system ,Pleurisy ,Epidemiology ,Medicine ,Persistent air leak ,Medical history ,lcsh:RC109-216 ,030212 general & internal medicine ,business - Abstract
A 31-year-old Hispanic male with no medical history was admitted for fevers, pleurisy, and cough after recent oral surgery and completing demolition and construction work in Juarez, Mexico. Imaging showed a 4.4 cm cavitary lesion and bilateral tree-in-bud opacities. Initial suspicion of bacterial infection confirmed with clinical improvement on culture specific antibiotics, but after discharge he returned with progression of symptoms and new dyspnea. Radiograph showed a pyopneumothorax. Chest computed tomography after thoracostomy showed worsening infiltrates and another cavitary lesion. Symptoms persisted despite addition of broad spectrum antibiotics. Surgical repair for persistent air leak was required. Weeks after discharge, cultures and serologies returned positive forCoccidioidomycosis immitis.Coccidioidesspecies cause up to 30% of community-acquired pneumonia and incidental cavitary lesions in endemic regions. Symptoms are nonspecific yet usually involve fatigue, cough, and pleurisy. Most hosts have spontaneous resolution; however, certain demographics such as Hispanics and diabetics, later diagnosed in our patient, have higher morbidity. As seen with our patient, cavitary rupture and bronchopleural fistulas are rare occurring in 2.6% of cavitary lesions. High suspicion based on symptoms and host demographics is important to assist in early diagnosis and treatment to avoid and treat this common pathogen’s presentations.
- Published
- 2015
165. LATE-BREAKING ABSTRACT: Surgical referral and complication rates in the ambulatory management of primary spontaneous pneumothorax: A retrospective analysis
- Author
-
Liju Ahmed, Jiyoon Yoon, Kevin O'Kane, and Parthipan Sivakumar
- Subjects
medicine.medical_specialty ,Referral ,business.industry ,Ambulatory ,medicine ,Retrospective analysis ,Persistent air leak ,Complication rate ,Primary spontaneous pneumothorax ,business ,Complication ,Surgery - Abstract
Introduction: Pocket chest devices permit the ambulatory management of primary spontaneous pneumothorax (PSP). Data on patient outcomes is limited. Aims: To evaluate the surgical referral for persistent air leak and complication rates at 6 months of PSP managed with a pneumostat device vs standard chest drain. Methods: We performed a retrospective case-control analysis of patients with PSP attending St Thomas' Hospital, London between February 2013 and December 2014. Results: 88 attendances (72 patients; median age 25 years) with PSP. [Table 1][1] . 21 patients were managed with an ambulatory drain vs 13 with standard chest drain. Complication rates were 2 (9%) vs 1 (4.5%). Surgical referral for persistent air leak 3 (13.6%) vs 3 (20%) (Fisher's exact p=0.652 ). Indications for ambulatory drain are shown in [Table 2][2] . View this table: Table 1 View this table: Table 2 Conclusion: The low surgical referral and complication rate suggest that ambulatory management of PSP with a pocket chest device is safe. This will require further evaluation prospectively. [1]: #T1 [2]: #T2
- Published
- 2015
166. Treatment of persistent air leak with endobronchial valves: a case report
- Author
-
Zehra Yasar, Erdoğan Çetinkaya, and Murat Acat
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,medicine ,Persistent air leak ,Surgery ,Critical Care and Intensive Care Medicine ,business - Published
- 2015
167. Efficacy of minimally invasive surgery in diagnosis of interstitial lung disease
- Author
-
Davood Attaran, Reza Bagheri, Seyed Ziaollah Haghi, Reza Basiri, Amir Mohammad Hashem Asnaashari, and Ata'ollah Rajabnejad
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Biopsy ,Anastomotic Leak ,Withdrawal time ,Iran ,Outcome Assessment, Health Care ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Surgical Wound Infection ,Hospital Mortality ,Retrospective Studies ,Lung ,medicine.diagnostic_test ,business.industry ,Thoracic Surgery, Video-Assisted ,Interstitial lung disease ,General Medicine ,Length of Stay ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Cardiothoracic surgery ,Invasive surgery ,Persistent air leak ,Female ,Reticular Pattern ,Cardiology and Cardiovascular Medicine ,business ,Lung Diseases, Interstitial ,Tomography, X-Ray Computed - Abstract
Objective This study aimed to evaluate the efficacy and safety of video-assisted thoracic surgery in reaching a specific diagnosis in patients with interstitial lung disease. Methods Thirty-eight patients with interstitial lung disease (19 males, 19 females; mean age 47.73 years) who had undergone video-assisted thoracic surgery at Ghaem Hospital, Mashhad, Iran, between 2010 and 2013 were evaluated retrospectively in this study. Preoperative evaluations including cardiac and pulmonary assessments were performed. Data were recorded in forms prepared for this study and included age, sex, symptoms, imaging findings, operation duration, chest drain withdrawal time, postoperative hospital stay, hospital mortality, and specific diagnosis of the disease. Results The most common symptom was dyspnea (38 patients, 100%). The most common computed tomography finding was a reticular pattern (30 patients, 78.94%). Surgery complications included persistent air leak in 3 (7.9%) cases and wound infection in 2 (5.26%). There was no hospital death and no need for reoperation. The average of operative time was 50 min. The mean time for chest drain withdrawal and postoperative hospitalization was 4 and 5 days, respectively. The most common diagnoses were usual interstitial pneumonia in 9 (23.68%) patients and sarcoidosis in 6 (15.78%). A specific diagnosis was not reached in 2/38 (5.26%) patients after video-assisted thoracic surgery. Conclusion Video-assisted thoracic surgery is a highly effective and safe method for establishing a specific diagnosis in patients with interstitial lung disease.
- Published
- 2015
168. Povidone-iodine for persistent air leak in an extremely low birth weight infant
- Author
-
Yavuz Yilmaz, Ugur Dilmen, Mehmet Yekta Oncel, Fuat Emre Canpolat, Sema Arayici, and Gülsüm Kadıoğlu Şimşek
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,High-Frequency Ventilation ,chemistry.chemical_element ,Infant, Premature, Diseases ,Iodine ,Injections ,law.invention ,law ,Humans ,Medicine ,Povidone-Iodine ,Pleurodesis ,Idiopathic chylothorax ,Respiratory Distress Syndrome, Newborn ,Extremely premature ,business.industry ,High-frequency ventilation ,Infant, Newborn ,Pneumothorax ,Pulmonary Surfactants ,General Medicine ,medicine.disease ,Respiration, Artificial ,Surgery ,chemistry ,Infant, Extremely Low Birth Weight ,Chest Tubes ,Infant, Extremely Premature ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Ventilation (architecture) ,Persistent air leak ,business ,Extremely low birth weight infant - Abstract
Chemical pleurodesis with povidone-iodine has been used to treat congenital idiopathic chylothorax in neonates. We report successful use of povidone-iodine in an extremely premature infant to treat a pneumothorax that had persisted for more than one week despite high-frequency ventilation.
- Published
- 2013
169. A prospective study of autologous ?blood patch? pleurodesis for persistent air leak after pulmonary resection
- Author
-
Loõ ¨ c Lang-Lazdunski and Aman S. Coonar
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Heart disease ,medicine.medical_treatment ,medicine ,Humans ,Prospective Studies ,Pneumonectomy ,Prospective cohort study ,Pleurodesis ,Aged ,Aged, 80 and over ,Lung ,business.industry ,Pneumothorax ,General Medicine ,Middle Aged ,medicine.disease ,Empyema ,Surgery ,Chest tube ,Blood ,medicine.anatomical_structure ,Persistent air leak ,Female ,Pulmonary resection ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objective: To evaluate the efficacy and risks of autologous ‘blood patch’ pleurodesis in patients with persistent air leak after pulmonary resection. Methods: 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 pleurodesis technique. Fifty millilitres of autologous blood were injected through the chest tube that was then rinsed, clamped for 30 min and then unclamped and placed back to water seal. Results :W e have obtained a 100% success rate in 11 patients with persistent air leak who have been treated with this technique over a 2-year period. Most air leaks (72.7%) ceased within 12 h of blood injection. No patient developed empyema, but two patients developed fever and pleural fluid grew Staphylococcus after blood pleurodesis. At 3-month follow-up, all patients were well and their lungs were expanded fully. Conclusions: In our experience a single injection of 50 ml of blood is sufficient to seal persistent air leaks in less than 48 h. Although highly effective, the autologous blood patch pleurodesis technique should not be used in patients with incomplete lung re-expansion or positive pleural fluid culture to minimize the risk of empyema. q 2004 Elsevier B.V. All rights reserved.
- Published
- 2004
170. Persistent air-leak following pulmonary resection
- Author
-
Thomas W. Rice, Ikenna C. Okereke, and Eugene H. Blackstone
- Subjects
Male ,Pulmonary and Respiratory Medicine ,Suction (medicine) ,medicine.medical_specialty ,medicine.medical_treatment ,Suction ,Severity of Illness Index ,Seal (mechanical) ,Pneumoperitoneum ,Surgical Stapling ,medicine ,Humans ,In patient ,Intraoperative Complications ,Pneumonectomy ,Postoperative Care ,business.industry ,Pneumothorax ,Prognosis ,medicine.disease ,Surgery ,Chest tube ,Chest Tubes ,Anesthesia ,Chronic Disease ,Persistent air leak ,Female ,Pulmonary resection ,business ,Complication - Abstract
Air leaks are an unavoidable complication of pulmonary resection. The definition of a persistent air leak is arbitrary and may even be irrelevant in solving the problem. Persistent air leaks are more common in patients with severe COPD, and preoperative interventions are ineffective in reducing their prevalence. Meticulous surgical technique and care in handling and resection of the pulmonary parenchyma are essential in preventing persistent air leaks. Buttressing parenchymal staple lines and creating a pleural tent or pneumoperitoneum should be reserved for patients at risk for persistent air leaks. The use of currently available sealants is ineffective for the treatment of this complication. To stop persistent air leaks, early cessation of suction and placing chest tubes to an underwater seal is more effective than continuous suction. The management of persistent air leaks may require provocative chest tube clamping and permissive chest tube removal or patient discharge from the hospital with a chest tube and a Heimlich valve.
- Published
- 2002
171. Endobronchial valve placement for the treatment of bronchopleural fistula: a review of the current literature
- Author
-
Jason Akulian, Judit Kuhn, and Olivia Giddings
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Fistula ,Treatment outcome ,Bronchopleural fistula ,Prosthesis Implantation ,Postoperative Complications ,Bronchoscopy ,Foreign-Body Migration ,mental disorders ,medicine ,Humans ,medicine.diagnostic_test ,business.industry ,Patient Selection ,Endobronchial valve ,Pneumonia ,Prostheses and Implants ,respiratory system ,Pleural Diseases ,medicine.disease ,respiratory tract diseases ,Surgery ,Prosthesis Failure ,Treatment Outcome ,Pneumothorax ,Persistent air leak ,Radiology ,Bronchial Fistula ,Lung resection ,Respiratory Tract Fistula ,business - Abstract
Bronchopleural fistula is a cause of increased morbidity and mortality. Patients who develop bronchopleural fistula after lung resection or spontaneous pneumothorax often have multiple co-morbidities making them poor candidates for repeated surgical intervention. Previous nonsurgical treatments for bronchopleural fistula have had limited success. Endobronchial valves, originally designed for bronchoscopic lung volume reduction, have been used under a humanitarian use exception for the treatment of bronchopleural fistula. Numerous case series and reports have been published; however, guidelines for the use of endobronchial valves specifically for bronchopleural fistula have yet to be developed.A number of case series and reports have described the use of one-way endobronchial valves for the treatment of bronchopleural fistula, after spontaneous pneumothorax, lung resection and complication of suppurative lung disease. In the largest series reported (40 patients), 93% of patients experienced improvement in air leak, with 48% having complete resolution. Other series have shown similar success. Complications are rare and include pneumonia, expectoration or migration of valves, and bacterial colonization.The use of endobronchial valves for the treatment of bronchopleural fistula is well tolerated and effective. Controlled clinical trials are needed to further evaluate their efficacy and identify ideal patient populations for their use.
- Published
- 2014
172. Management of the pediatric spontaneous pneumothorax: is primary surgery the treatment of choice?
- Author
-
Sara C. Fallon, Mary L. Brandt, Monica E. Lopez, Timothy C. Lee, Mark V. Mazziotti, and J. Ruben Rodriguez
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Decision Making ,Thoracostomy ,Young Adult ,Recurrence ,medicine ,Effective treatment ,Humans ,Prospective cohort study ,Child ,Pleurodesis ,Retrospective Studies ,business.industry ,Thoracic Surgery, Video-Assisted ,Oxygen Inhalation Therapy ,Pneumothorax ,General Medicine ,Primary spontaneous pneumothorax ,medicine.disease ,Nonoperative treatment ,Surgery ,Treatment Outcome ,Video-assisted thoracoscopic surgery ,Persistent air leak ,Female ,business ,Follow-Up Studies - Abstract
Surgery as the primary management strategy for pediatric primary spontaneous pneumothorax is controversial. This study aims to evaluate the outcomes and effectiveness of management approaches for pediatric spontaneous pneumothorax.Outcomes of pediatric patients undergoing initial nonoperative treatment versus video-assisted thoracoscopic surgery with blebectomy and mechanical pleurodesis were compared via a retrospective review.We identified 96 patients with 108 pneumothoraces. Of 98 pneumothoraces with initial nonoperative management, 37% had surgery during their initial hospitalization for persistent air leak. Of those discharged home without video-assisted thoracoscopic surgery, 40% recurred. Initial nonoperative management resulted in more total hospital days (median: 11 vs 5 days, P.001). No significant predictors of recurrence were identified on multivariate analysis. Sixty-three percent of all patients ultimately required surgery.Fewer than 40% of primary spontaneous pneumothorax patients are definitively treated with nonoperative management. A prospective study is needed to determine whether primary surgery with blebectomy/mechanical pleurodesis is a more effective treatment strategy.
- Published
- 2014
173. Extracellular matrix pleural tent for persistent air leak and air space in a child after upper lobectomy
- Author
-
Patrick I. McConnell
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Air leak ,Extracellular matrix ,Postoperative Complications ,medicine ,Humans ,Pneumonectomy ,Lung ,business.industry ,Air ,Congenital pulmonary airway malformation ,Infant ,respiratory system ,medicine.disease ,Complete resolution ,respiratory tract diseases ,Surgery ,Extracellular Matrix ,body regions ,medicine.anatomical_structure ,Persistent air leak ,Pleura ,Air space ,Pulmonary resection ,Cardiology and Cardiovascular Medicine ,business - Abstract
Creation of a pleural tent is effective in reducing persistent air leaks after pulmonary resection. I report a case of a pleural-like tent being created out of extracellular matrix to treat a persistent air leak in child after upper lobectomy for a large congenital pulmonary airway malformation type II. Over the next year, ipsilateral lung expansion and growth occurred with near complete resolution of the apical air space.
- Published
- 2013
174. Management of spontaneous pneumothorax---a Welsh survey
- Author
-
J H Yeoh, S Ansari, and I A Campbell
- Subjects
medicine.medical_specialty ,Pediatrics ,business.industry ,General surgery ,Respiratory disease ,Accident and emergency ,General Medicine ,medicine.disease ,Asymptomatic ,language.human_language ,Respiratory Medicine ,Welsh ,Pneumothorax ,Current practice ,medicine ,language ,Persistent air leak ,medicine.symptom ,business - Abstract
The authors sought to determine to what degree current practice by hospital physicians and accident and emergency (A&E) departments in Wales conformed to the British Thoracic Society's guidelines for the management of spontaneous pneumothorax. Questionnaires were posted to all consultants involved in emergency medical admissions in Wales (149 consultant physicians and 23 A&E consultants) of whom 101 (59%) replied. Only 45% used the classification, "small, moderate, or complete" to describe the size of pneumothorax. Just 44% would do as recommended by the British Thoracic Society and discharge an asymptomatic patient with a primary pneumothorax and 34% would discharge a patient with a primary pneumothorax after successful aspiration. Only 20% were prepared to try aspiration initially for a secondary pneumothorax with a complete lung collapse. Thirty four per cent would follow the recommendation to remove a chest drain without prior clamping of the tube 24 hours after bubbling had stopped. In the event of a persistent air leak 69% would refer patients or seek a specialist opinion. Physicians with an interest in respiratory medicine tolerated persistent air leaks for significantly longer than did non-respiratory physicians (median of 7 v 5 days, p=0.001). The survey indicates that fewer than expected consultant physicians and A&E consultants in Wales manage spontaneous pneumothoraces in the way recommended by the guidelines. Physicians with an interest in respiratory medicine tended to comply with these guidelines more than general physicians with interests other than respiratory medicine or A&E consultants but the trend was not significant at the 5% level. It is felt that the guidelines should be disseminated more widely, ensuring that emergency admissions units and A&E departments have copies on display or easily accessible, and that they could be expanded to cover other aspects such as timing for surgery. Keywords: pneumothorax; non-compliance with guidelines
- Published
- 2000
175. A prospective evaluation of video-assisted thoracic surgery for persistent air leak due to trauma
- Author
-
Brian D Matteson, Roxie M Albrecht, Victor H Davis, Carol R Schermer, and Gerald B Demarest
- Subjects
Male ,Thorax ,medicine.medical_specialty ,Time Factors ,Thoracic Injuries ,medicine.medical_treatment ,Air leak ,medicine ,Thoracoscopy ,Humans ,Prospective Studies ,Prospective cohort study ,Hemothorax ,medicine.diagnostic_test ,business.industry ,Pneumothorax ,Endoscopy ,General Medicine ,Length of Stay ,Surgery ,Chest tube ,Cardiothoracic surgery ,Chest Tubes ,Video assisted thoracic surgery ,Anesthesia ,Persistent air leak ,Female ,business - Abstract
Background: The time required for air leak resolution after chest trauma is not well described. Based on an institutional review of posttraumatic air leaks our hypothesis was that video-assisted thoracic surgery (VATS) for persistent posttraumatic air leak would decrease chest tube days and length of stay compared with nonoperative management. Methods: Patients were offered VATS versus nonoperative management when air leaks persisted longer than 3 days and the patients were otherwise ready for discharge. Chest tube days and length of stay were recorded. Results: Of 223 trauma patients requiring chest tubes, 50 had persistent air leaks, 39 of whom were otherwise ready for discharge. Twenty-five chose VATS and 14 nonoperative (NOP) treatment. The mean chest tube days was 8.1 for VATS versus 11.8 for NOP (P = 0.001). Mean length of stay was 9.7 days for VATS and 16.5 days for NOP (P = 0.002). Conclusions: In patients otherwise ready for discharge VATS reduces chest tube days and length of stay when used to treat persistent posttraumatic air leak.
- Published
- 1999
176. O-132EFFICACY OF SURGICAL SEALANTS FOR PERSISTENT AIR LEAK AFTER LUNG RESECTION: INDIVIDUAL PATIENT DATA META-ANALYSIS FROM TWO RANDOMIZED TRIALS
- Author
-
N. Asadi, Maria Elena Cufari, P. Perikleous, Michael Dusmet, George Ladas, Elizabeth Belcher, May Al-Sahaf, H. Raubenheimer, Simon Jordan, Chiara Proli, and Eric Lim
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Patient data ,Surgery ,law.invention ,Randomized controlled trial ,law ,Meta-analysis ,medicine ,Persistent air leak ,Lung resection ,Cardiology and Cardiovascular Medicine ,business - Published
- 2015
177. Tratamento do pneumotórax espontâneo por videotoracoscopia
- Author
-
Luís Gonçalves, Gomes Mr, Jorge Casanova, Pedro Bastos, Luís A. Rocha, and Maria Rosa Cruz
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Tale pleurodesis ,medicine.medical_treatment ,medicine ,Recurrent pneumothorax ,Thoracotomy ,Videothoracoscopy ,Pleurodese com talco ,Videotoracoscopia ,lcsh:RC705-779 ,Lung ,business.industry ,lcsh:Diseases of the respiratory system ,medicine.disease ,Surgery ,Pneumotórax espontâneo ,medicine.anatomical_structure ,Pneumothorax ,Cardiothoracic surgery ,Anesthesia ,Persistent air leak ,Spontaneous pneumothorax ,Bleb (medicine) ,business ,Pleurodesis - Abstract
RESUMO: A cirurgia toráeica videoassistida é um método recente de tratamento do pneumotórax espontãneo, Revemos a nossa experiência com 46 doentes (dts) consecutivos, 10 do sexo feminino e 36 do sexo masculino, com idades compreendidas entre os 17 e us 73 anos (media 38.3 anos), que foram submetidos a 49 videotorncoscopias entre 1993 e 1996. A indicação cÃrúrgica resultou da existência de pneumotórax recorrente em 17 dts. de pneumotórax bilateral em 3 dts e de fuga aérea persistete em 26 doentes.As bolhas pulmonares foram ressecadas por âstapplingâ em 30 dts e electrocomaguladas em 3 outros. Em todos os doentes foi efectuada uma abrasão pleural, de tipo mecânico em 10 casos e com talco farmaeêutico sem asbesto nos restantes trinta e seis. Não houve mortalidade operatória. Um doente (2,1 %) foi reoperndo por hemorragia e um outro·(2,1%) por fuga aérea persistente. Os tempos médios de drenagem torácica e de internamento posoperatório foram de, respectivamente, 39,5 boras (máximo 264, minimo 18) e 2,9 dias (máximo 12, minimo 1). âO follow-upâ oscillou entre 1 e 46 meses (média 14,4 meses). Não se registou nenhom caso de recorrência de pneumotórax, mantendo todoc 0 s doentes uma expansâo pulmonar completa. Estes dados sugerem que a videotoracoscopia é urna alternativa válida á toracotomia clássica no tratamento do poeumotórax esponãnco. O tempo de ioternomcoto é mais curto, a morbilidade é mais baixa e os resultados á distância são excelentes.REV PORT PNEUMOL. 1998; IV (3): 287-193 ABSTRACT: Video-assisted thoracic surgery has recently evolved as an alternative to thoracoromy in the treatment of spontaneous pneumothorax. We reviewed 46 consecutive patients (10 female and 36 male patients, aged 17 to 73 years. mean 38.3) who underwent 49 video-assisted thorcic procedures between 1993 e 1996. Seventeen patients had recurrent ipsilateral pneumonthorax, 3 patients bilateral pneumothorax and 26 patients persistent air leak. The must common method of management was âstapling' of an identified bleb in the lung wich was undertaken in 30 (65%.) patients. A pleurodesis was performed in every operated patient; 10 patients had mechanical abrasion while the instillation of tale was used in. 36 patients. There was no operative mortality. One patient (2,1%) had to be reoperated for bleeding and another one (2,1 %) for persistent air leak. Postoperative thoracie drainage ranged from 18 to 164 hours (mean 39.5) and postoperative stay from 1 to 12 days (mean 2.9). Mean follow-up was 24.4 months and ranged from 1 to 46 months. There were no instances of recurrent pneumothorax. These data suggest that video-assisted thoracic surgery is n viable alternative to thoracotomy for the treatment of spontaneous pneumothorax. It results in a short hospital stay, tow morbidity and excellent long term results.REV PORT PNEUMOL. 1998; IV (3): 287-193 Key-words: Spontaneous pneumothorax, Videothoracoscopy, Tale pleurodesis, Palavras-chaver: Pneumotórax espontâneo, Videotoracoscopia, Pleurodese com talco
- Published
- 1998
178. Use of a single silastic chest drain following thoracotomy: initial evaluation
- Author
-
Nand Kejriwal and Mark A.J. Newman
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Pleural effusion ,medicine.medical_treatment ,Silicones ,Bronchopleural fistula ,Insertion site ,medicine ,Humans ,Dimethylpolysiloxanes ,Thoracotomy ,Aged ,Aged, 80 and over ,Postoperative Care ,Chest drains ,business.industry ,General Medicine ,Middle Aged ,Pleural cavity ,Silastic ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Chest Tubes ,Anesthesia ,Drainage ,Persistent air leak ,Female ,business - Abstract
Background: It is standard practice to use multiple large bore semi-rigid chest tubes to drain the pleural cavity following thoracic procedures. These can cause pain and discomfort at the insertion site. Methods: We describe our experience with the use of a single small silastic drain following thoracotomy. From November 2001 to November 2003, size19-F silastic chest tubes (Blake drains) were used for drainage of the pleural cavity in 37 patients at our institution. The patients ranged in age from 18 to 81 years (mean 65). The operations included 22 lobectomies, two bilobectomies, 10 wedge resections, and three other procedures. Results: Total drainage in each patient ranged from 420 to 5440 mL (mean 1387 mL). Tubes were left in place for an average of 4.3 days (range 1−12). The average postoperative length of stay was 7.6 days (range 3−44, median 5). Three patients required insertion of an additional tube for dislodgement, persistent air leak, and bronchopleural fistula, respectively. These complications occurred among the first 15 patients in the present series. None of the patients had persistent pleural effusion. Subjectively, these tubes were more comfortable for the patients and were easier to remove. Summary: The use of a single, small silastic chest drains following thoracotomy may be safe and effective in draining both fluid and air, though an additional tube may be necessary for persistent leaks.
- Published
- 2005
179. P-232THE USE OF PEZZER CATHETER IN PERSISTENT AIR LEAK
- Author
-
Kalliopi Athanassiadi, Nikolaos A. Papakonstantinou, Athanasia Makrygianni, and Ioannis Alevizakis
- Subjects
Pulmonary and Respiratory Medicine ,Catheter ,medicine.medical_specialty ,business.industry ,Anesthesia ,Pulmonary air leakage ,medicine ,Persistent air leak ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Published
- 2016
180. ePS05.2 Autologous blood patch pleurodesis for persistent air leak in adults with cystic fibrosis
- Author
-
Joanna L. Whitehouse, Edward F. Nash, L. Dirmantaite, C. Baker, and R. Rashid
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Pediatrics, Perinatology and Child Health ,Autologous blood ,Medicine ,Persistent air leak ,business ,medicine.disease ,Pleurodesis ,Cystic fibrosis ,Surgery - Published
- 2016
181. Fibrin Glue for Persistent Pneumothorax in Neonates
- Author
-
Shikha Sarkar, Naveed Hussain, and Victor C. Herson
- Subjects
Male ,Bradycardia ,medicine.medical_specialty ,Fibrin Tissue Adhesive ,Diaphragmatic paralysis ,medicine ,Humans ,Persistent pneumothorax ,Effective treatment ,Fibrin glue ,business.industry ,Infant, Newborn ,Pneumothorax ,Obstetrics and Gynecology ,medicine.disease ,Respiratory Paralysis ,Surgery ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Hypercalcemia ,Tissue necrosis ,Persistent air leak ,Female ,Tissue Adhesives ,medicine.symptom ,business - Abstract
Fibrin glue was used to treat significant pneumothoraces persisting for an average of 10 days in eight newborns. Six of the eight infants had reduction or resolution of persistent air leak within 24 hours of therapy. Two infants received a second course of therapy for recurrences. Complications encountered were bradycardia requiring manual ventilation (N=2), significant hypercalcemia (N=2), diaphragmatic paralysis (N=2), pneumothorax (PTX) on the contralateral side (N=1), and localized tissue necrosis (N=1). Fibrin glue is an effective treatment for intractable PTX but has significant risks.
- Published
- 2003
182. Endobronchial Valve Placement as Destination Therapy for Recurrent Pneumothorax in the Setting of Advanced Malignancy.
- Author
-
Gilbert, Christopher R., Toth, Jennifer W., Osman, Umar, and Reed, Michael F.
- Subjects
CHEST X rays ,COMPUTED tomography ,ENDOSCOPY ,PNEUMOTHORAX ,ACUTE myeloid leukemia ,SUBCUTANEOUS emphysema - Abstract
The development of a persistent air leak after pneumothorax can be encountered in patients with underlying structural lung disease. In those with advanced malignancy or other comorbidities, the ability to tolerate general anesthesia and thoracoscopic procedures may limit definitive management. We describe the case of a 68-y-old male with refractory acute myelogenous leukemia presenting with recurrent secondary spontaneous pneumothorax and persistent air leak related to an underlying fungal pneumonia. Endobronchial valve placement allowed for timely chest tube removal and discharge from the hospital, as well as avoidance of a thoracoscopic procedure and pleurodesis. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
183. Endobronchial valve migration
- Author
-
Malgorzata Kornaszewska, Paul Vaughan, Melanie Jenkins, and David Place
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung volume reduction surgery ,Air leak ,Foreign-Body Migration ,medicine ,Humans ,Lung ,Respiratory Tract Infections ,Thoracic Surgery, Video-Assisted ,business.industry ,Respiratory disease ,Endobronchial valve ,Prostheses and Implants ,General Medicine ,Middle Aged ,medicine.disease ,Lobe ,Surgery ,Radiography ,medicine.anatomical_structure ,Pulmonary Emphysema ,Circulatory system ,Persistent air leak ,Cardiology and Cardiovascular Medicine ,business ,Body orifice - Abstract
Endobronchial valves are increasingly used as a treatment modality as a less invasive alternative to lung volume reduction surgery in patients with severe emphysema. Endobronchial valves have also been used to treat patients with persistent pulmonary air leaks and those with bronchopleural fistulae. We report a case of a 61-year-old male with severe bullous emphysema. Following video-assisted thoracoscopic surgery and giant bullectomy, he had a persistent air leak. We inserted two endobronchial valves (in the lingular lobe and the anterior segment of the upper lobe) and the air leak ceased immediately. However, over the subsequent 5 months following the insertion of the endobronchial valves, the patient suffered recurrent chest infections and the endobronchial valves were found to have migrated to the orifice of the basal segment of the left lower lobe and the orifice of the basal segments of the right lower lobe.
- Published
- 2011
184. Endobronchial Valve for Secondary Pneumothorax in a Severe Emphysema Patient
- Author
-
Federico Rea, Marco Schiavon, Andrea Zuin, U. Fantoni, F. De Filippis, Samuele Nicotra, G. Marulli, and F. Di Chiara
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Myocardial Infarction ,Pulmonary disease ,Bronchi ,Severity of Illness Index ,Pulmonary Disease, Chronic Obstructive ,Fatal Outcome ,Bronchoscopy ,Recurrence ,Risk Factors ,Internal medicine ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Aged ,Lung ,medicine.diagnostic_test ,business.industry ,Endobronchial valve ,Pneumothorax ,Prostheses and Implants ,medicine.disease ,Subcutaneous Emphysema ,Surgery ,medicine.anatomical_structure ,Pulmonary valve ,Cardiology ,Myocardial infarction complications ,Persistent air leak ,Cardiology and Cardiovascular Medicine ,business - Abstract
Secondary pneumothorax represents a challenging problem in patients with chronic obstructive pulmonary disease, due to their compromised health status. In this case, an endobronchial one-way valve was inserted in the left lower lobe by flexible bronchoscopy, resulting in a complete resolution of air leak and lung reexpansion. Endobronchial valve could represent a new option for the management of persistent air leak in patients not suitable for surgical procedures.
- Published
- 2011
185. Intrapleural quinacrine instillation for recurrent pneumothorax or persistent air leak
- Author
-
Fritz E. Derom, H Janzing, Eric Derom, M. T. Rosseel, Catharina Eeckhout, and A Derom
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Side effect ,medicine.medical_treatment ,Mepacrine ,Recurrence ,medicine ,Humans ,Aged ,Retrospective Studies ,business.industry ,Air ,Respiratory disease ,Pneumothorax ,Middle Aged ,medicine.disease ,Surgery ,Regimen ,Effusion ,Quinacrine ,Anesthesia ,Pleura ,Persistent air leak ,Female ,Cardiology and Cardiovascular Medicine ,business ,Pleurodesis ,medicine.drug - Abstract
From 1982 to 1990, 27 patients with recurrent pneumothorax or persistent air leak (28 episodes) underwent pleurodesis with intrapleural administration of quinacrine, according to a standardized scheme. A first evaluation was done about 1 month after the intervention. In August 1990, all patients were invited for a second check-up. In 4 patients quinacrine plasma concentrations were determined. There was one early failure. No late recurrences were observed. Neither serious nor late complications were seen with our low-dose regimen. Transient fever was the only constant side effect. In contrast to other chemicals proposed for pleurodesis, quinacrine did not cause major pain. Only very low quinacrine plasma concentrations (peak
- Published
- 1993
186. Life-threatening complications related to minocycline pleurodesis
- Author
-
Jang-Ming Lee, Chia-Ying Li, and Shuenn-Wen Kuo
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Fistula ,medicine.medical_treatment ,Bronchopleural fistula ,Bronchi ,Minocycline ,Postoperative air leak ,Diagnosis, Differential ,Pneumonectomy ,Bronchoscopy ,medicine ,Humans ,Pleurodesis ,Aged ,medicine.diagnostic_test ,business.industry ,Pleural Diseases ,medicine.disease ,Surgery ,Anti-Bacterial Agents ,Anesthesia ,Persistent air leak ,Bronchial Fistula ,Pulmonary resection ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed ,medicine.drug ,Follow-Up Studies - Abstract
For decades, chemical pleurodesis using minocycline has been widely accepted as an effective, safe, and cheap treatment for persistent air leak after pulmonary resection. We report a case with persistent postoperative air leak that suffered from cardiorespiratory arrest just after a minocycline pleurodesis, which may be related to the aspiration of minocycline solution from a bronchopleural fistula. Therefore, we suggest a bronchoscopic examination be performed before the pleurodesis if a bronchopleural fistula is highly suspected.
- Published
- 2010
187. Intrapleural instillation of autologous blood for persistent air leak in spontaneous pneumothorax- is it as effective as it is safe?
- Author
-
Marios E. Daskalopoulos, Theocharis Koufakis, Dimitrios Papadopoulos, Athanasios Drakos, Nicholaos Desimonas, Nikolaos Tsilimingas, Dimos Karangelis, Georgios I Tagarakis, Georgios Skoumis, and Vasileios Saleptsis
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,Blood transfusion ,medicine.medical_treatment ,Autologous blood ,lcsh:Surgery ,Thoracostomy ,lcsh:RD78.3-87.3 ,Blood Transfusion, Autologous ,Young Adult ,Study Protocol ,medicine ,Humans ,Prospective Studies ,Pleurodesis ,Aged ,business.industry ,Air ,Pneumothorax ,lcsh:RD1-811 ,General Medicine ,medicine.disease ,respiratory tract diseases ,Surgery ,Cardiac surgery ,surgical procedures, operative ,lcsh:Anesthesiology ,Cardiothoracic surgery ,Anesthesia ,Chest Tubes ,Persistent air leak ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objective 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. Patients and methods A number of 15 patients (10 male and 5 female) were included in this prospective study between March 2005 and December 2009. The duration of the air leak exceeded 7 days in all patients. The application of blood pleurodesis was used as the last preoperative conservative method of treatment in 12 patients. One patient refused surgery and two were ineligible for operation due to their comorbidities. A blood sample of 50 ml was obtained from the patient's femoral vein and immediately introduced into the chest tube. Results A success rate of 27% was observed having the air leak sealed in 4 patients in less than 24 hours. Conclusion Despite our disappointingly poor outcome, the authors believe that the procedure's safety, convenience and low cost establish it as a worth trying method of conservative treatment for patients with the aforementioned pathology for whom no other alternative than surgery would be a choice.
- Published
- 2010
188. Iatrogenic Air Leak Successfully Treated by Bronchoscopic Placement of Unidirectional Endobronchial Valves
- Author
-
Alfonso Fiorelli, Mario Santini, Giovanni Vicidomini, Paolo Laperuta, Vincenzo Giuseppe Di Crescenzo, Santini, Mario, Fiorelli, Alfonso, Vicidomini, Giovanni, Laperuta, P, and Di Crescenzo, Vg
- Subjects
Lung Diseases ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Fistula ,Iatrogenic Disease ,Pulmonary Surgical Procedures ,Air leak ,Bronchoscopy ,medicine ,Humans ,Bulla (seal) ,Surgical repair ,Lung ,Lung Diseases/therapy ,medicine.diagnostic_test ,business.industry ,Air ,Remission Induction ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Left upper lobe ,Pulmonary Surgical Procedures/instrumentation ,Persistent air leak ,Cardiology and Cardiovascular Medicine ,business - Abstract
This report describes a patient with persistent air leak after inadvertent placement of a chest drain in a bulla. Chest drain and suction failed to stop the air leak, whereas the surgical repair was judged to be excessively aggressive. In closure, two large endobronchial valves were sequentially positioned in the superior and inferior division of the left upper lobe to completely close it. The result was the collapse of bulla with closure of fistula and complete lung expansion. (Ann Thorac Surg 2010; 89: 2007-10) (C) 2010 by The Society of Thoracic Surgeons
- Published
- 2010
189. Management of patients with persistent air leak after elective pulmonary resection
- Author
-
Chee Fui Chong
- Subjects
Pulmonary and Respiratory Medicine ,Postoperative Care ,medicine.medical_specialty ,Wound Healing ,business.industry ,Pneumothorax ,Suction ,Surgery ,Radiography ,Postoperative Complications ,Chest Tubes ,medicine ,Persistent air leak ,Humans ,Pulmonary resection ,Cardiology and Cardiovascular Medicine ,business ,Pneumonectomy ,Device Removal ,Pleurodesis - Published
- 2009
190. Rapidly progressive Bronchiolitis Obliterans Organising Pneumonia presenting with pneumothorax, persistent air leak, acute respiratory distress syndrome and multi-organ dysfunction: a case report
- Author
-
Indranil Chakravorty, William L. G. Oldfield, and Carlos M H Gómez
- Subjects
Medicine(all) ,Acute coronary syndrome ,medicine.medical_specialty ,Pediatrics ,Respiratory distress ,business.industry ,lcsh:R ,Bronchiolitis obliterans ,lcsh:Medicine ,Case Report ,General Medicine ,Acute respiratory distress ,medicine.disease ,Organising pneumonia ,Pneumothorax ,Intensive care ,medicine ,Persistent air leak ,business ,Intensive care medicine - Abstract
Introduction Bronchiolitis Obliterans Organising Pneumonia (BOOP) may often present initially as a recurrent spontaneous pneumothorax and then develop multi-system complications. Case presentation A 17-year-old boy presented with a pneumothorax, which developed into rapidly progressive Bronchiolitis Obliterans Organising Pneumonia (BOOP). He developed multi-organ dysfunction (including adult respiratory distress syndrome, oliguric renal failure, acute coronary syndrome, cardiac failure and a right atrial thrombus) which necessitated prolonged intensive care. Diagnosis was confirmed on open lung biopsy and he responded well to treatment with corticosteroids. Conclusion BOOP is exquisitely sensitive to oral corticosteroids but if the diagnosis is not considered in such patients and appropriate treatment instituted early, BOOP may often lead to prolonged hospital admission with considerable morbidity.
- Published
- 2008
191. P-194ENDOBRONCHIAL VALVES IN THE TREATMENT OF PERSISTENT AIR LEAK AND EMPYEMA AFTER LUNG RESECTION: A USEFUL TOOL FOR THORACIC SURGEONS
- Author
-
R. Giuliano, Giacomo Cusumano, C. Riscica Lizzio, M. D'Arrigo, Alberto Terminella, Ignazio Vasta, Salvatore Bellofiore, Rosalia Giarlotta, and Salvatore Saita
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,medicine ,Persistent air leak ,Surgery ,Lung resection ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,Empyema - Published
- 2015
192. A clinical prediction model for prolonged air leak after pulmonary resection.
- Author
-
Attaar, Adam, Winger, Daniel G., Luketich, James D., Schuchert, Matthew J., Sarkaria, Inderpal S., Christie, Neil A., and Nason, Katie S.
- Abstract
Objective Prolonged air leak increases costs and worsens outcomes after pulmonary resection. We aimed to develop a clinical prediction tool for prolonged air leak using pretreatment and intraoperative variables. Methods Patients who underwent pulmonary resection for lung cancer/nodules (from January 2009 to June 2014) were stratified by prolonged parenchymal air leak (>5 days). Using backward stepwise logistic regression with bootstrap resampling for internal validation, candidate variables were identified and a nomogram risk calculator was developed. Results A total of 2317 patients underwent pulmonary resection for lung cancer/nodules. Prolonged air leak (8.6%, n = 200) was associated with significantly longer hospital stay (median 10 vs 4 days; P < .001). Final model variables associated with increased risk included low percent forced expiratory volume in 1 second, smoking history, bilobectomy, higher annual surgeon caseload, previous chest surgery, Zubrod score >2, and interaction terms for right-sided thoracotomy and wedge resection by thoracotomy. Wedge resection, higher body mass index, and unmeasured percent forced expiratory volume in 1 second were protective. Derived nomogram discriminatory accuracy was 76% (95% confidence interval [CI], 0.72-0.79) and facilitated patient stratification into low-, intermediate- and high-risk groups with monotonic increase in observed prolonged air leaks (2.0%, 8.9%, and 19.2%, respectively; P < .001). Patients at intermediate and high risk were 4.80 times (95% CI, 2.86-8.07) and 11.86 times (95% CI, 7.21-19.52) more likely to have prolonged air leak compared with patients at low risk. Conclusions Using readily available candidate variables, our nomogram predicts increasing risk of prolonged air leak with good discriminatory ability. Risk stratification can support surgical decision making, and help initiate proactive, patient-specific surgical management. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
193. [Effectiveness and complications of video-assisted surgery for primary spontaneous pneumothorax]
- Author
-
F.J. Moradiellos, Carmen Marrón, V. Díaz-Hellín, J.A. Pérez-Antón, A. Gómez-Caro, J.L. Martín de Nicolás, and E. Larrú
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Stage ii ,Postoperative Complications ,Medicine ,Humans ,Thoracotomy ,Stage (cooking) ,Retrospective Studies ,business.industry ,Thoracic Surgery, Video-Assisted ,Pleural empyema ,Pneumothorax ,General Medicine ,Primary spontaneous pneumothorax ,Video-Assisted Surgery ,medicine.disease ,respiratory tract diseases ,Surgery ,Anesthesia ,Persistent air leak ,Female ,business - Abstract
Objective To assess the effectiveness and describe the complications of video-assisted thoracoscopic surgery (VATS) for the treatment of primary spontaneous pneumothorax. Patients and methods Between May 1997 and September 2003, our department scheduled 147 VATS procedures for spontaneous pneumothorax in 127 patients (102 men [80.5%]). The mean (SD) age for the series was 28.3 (11.6) years. Bullae and blebs were resected by endostapler and vigorous pleural abrasion was carried out. Vanderschueren staging was as follows: stage I, 10 (6.8%); stage II, 22 (15%); stage III, 71 (48.3%); and stage IV, 44 (29.9%). The procedure was indicated for the following reasons: third episode, 56 (38.1%); persistent air leak, 47 (32%); elective, 16 (10.9%); simultaneous bilateral pneumothorax, 28 (19%). VATS was performed on the right side only in 85 patients (57.8%), on the left in 62 (42.2%), and on both sides in 16 (11.6%). Results A total of 137 of the 147 VATS procedures scheduled (93.2%) were performed, and there were no deaths. The rate of conversion to thoracotomy was 6.8%, and the overall rate of complications was 13.7%. Postoperative complications were due to bleeding in 5 cases (3.6%), air leak (>5 days) in 10 (7.2%), wound infection in 2 (1.4%), residual pneumothorax in 4 (2.9%), need to insert a new pleural drain in 3 (2.1%), and pleural empyema in 1 (0.7%). Two patients took oral analgesics for more than 30 days after the procedure. Pneumothorax recurred during follow-up in 7 patients (5.1%). No significant correlation was found between recurrence of pneumothorax after VATS and Vandeschueren stage, age, bilaterality of the procedure, indication, or days of postoperative drainage (P>.05). Conclusions VATS for resection of pleural lesions plus pleural abrasion is an efficacious and simple treatment for primary spontaneous pneumothorax regardless of intraoperative findings.
- Published
- 2006
194. Closure of a bronchopleural fistula using bronchoscopic placement of an endobronchial valve designed for the treatment of emphysema
- Author
-
Kimberly Sprenger, J. Scott Ferguson, and Timothy L. Van Natta
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Bronchopleural fistula ,Critical Care and Intensive Care Medicine ,Bronchoscopy ,medicine ,Humans ,In patient ,medicine.diagnostic_test ,business.industry ,Thoracoscopy ,Respiratory disease ,Endobronchial valve ,Pneumothorax ,Prostheses and Implants ,Middle Aged ,Pleural Diseases ,medicine.disease ,Bronchial Fistula ,Surgery ,Pulmonary Emphysema ,Persistent air leak ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Pneumothoraces are sometimes complicated by a persistent air leak or bronchopleural fistula requiring prolonged chest tube drainage. Non-surgical treatment of persistent bronchopleural fistulas is often performed in patients who are poor surgical candidates, but the ideal method of closure is not known. Here we report closure of a persistent distal bronchopleural fistula using a one-way endobronchial valve designed for the treatment of emphysema.
- Published
- 2006
195. Comparing the Outcomes of Surgical vs Nonsurgical Treatment of Persistent Air-Leak in Primary Spontaneous Pneumothorax
- Author
-
Augustine Tee, Akash Verma, and Tunn Ren Tay
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Pulmonary air leakage ,Primary spontaneous pneumothorax ,Critical Care and Intensive Care Medicine ,Nonsurgical treatment ,Persistence (computer science) ,Surgery ,Anesthesia ,Medicine ,Persistent air leak ,Cardiology and Cardiovascular Medicine ,business - Published
- 2014
196. Video-assisted thoracic surgery (VATS) for spontaneous pneumothorax
- Author
-
S. McKenna, D. Lannon, A. E. Wood, and J. McCarthy
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Video Recording ,Postoperative Complications ,Recurrence ,medicine ,Humans ,Hospital Mortality ,Thoracotomy ,Aged ,Aged, 80 and over ,Endoscopes ,business.industry ,Pneumothorax ,General Medicine ,Middle Aged ,Thoracoscopes ,medicine.disease ,Surgery ,Survival Rate ,Chest tube ,Cardiothoracic surgery ,Anesthesia ,Video assisted thoracic surgery ,Bilateral pneumothorax ,Persistent air leak ,Female ,business ,Pleurectomy - Abstract
Video-assisted thoracic surgery (VATS) involves using a thoracoscope with a camera chip attached to a video monitor which allows certain thoracic procedures to be performed with limited incisions. Using VATS, 170 procedures have been performed on 158 patients including 42 procedures on 39 patients with spontaneous pneumothorax. There were 24 males and 15 females with age ranging from 17 to 84 yr (mean 36.7). Indication for operation included recurrent pneumothorax in 20 (51 per cent), persistent pneumothorax in 16 (41 per cent) and bilateral pneumothorax in 3 (8 per cent). The main therapeutic strategies were apical pleurectomy, in all (42) and blebectomy/bullectomy in 38 (90 per cent). There was one hospital death (hospital mortality 2.5 per cent) in an elderly patient who developed multi organ failure post bullectomy and persistent air leak. One patient (2.5 per cent) required conversion to formal thoracotomy. Mean post-operative chest tube duration was 2.7 days and mean post-operative hospital stay was 5.1 days. There has been no recurrence of pneumothorax in this series during short term follow up (mean 18 months). Our experience indicates an expanding role for video-assisted thoracic surgery in the management of patients with spontaneous pneumothorax.
- Published
- 1997
197. Chest bottle 'foam' problem caused by persistent air leak: an alternative solution
- Author
-
Mu Yen Lin, Ming Ho Wu, Yau Lin Tseng, Jia Ming Chang, I. Lin Shu, and Wu Wei Lai
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.product_category ,Chemical Phenomena ,Ethanol ,business.industry ,Chemistry, Physical ,Air ,Proteins ,Suction ,Surgery ,Body Fluids ,Postoperative Complications ,Chest Tubes ,medicine ,Bottle ,Simethicone ,Persistent air leak ,Humans ,Pleura ,Surface Tension ,Cardiology and Cardiovascular Medicine ,business ,Pneumonectomy - Published
- 2005
198. Endobronchial valves for treatment of bronchopleural fistula
- Author
-
Theresa M. Boley, Kristofer M. Mitchell, and Stephen R. Hazelrigg
- Subjects
Pulmonary and Respiratory Medicine ,Thorax ,Male ,medicine.medical_specialty ,business.industry ,Thoracoscopy ,Respiratory disease ,Bronchopleural fistula ,Pneumothorax ,Lung volume reduction surgery ,medicine.disease ,Surgery ,Patient population ,Postoperative Complications ,Quality of life ,Arterio-Arterial Fistula ,Asbestosis ,medicine ,Persistent air leak ,Humans ,Cardiology and Cardiovascular Medicine ,business ,Lung ,Aged - Abstract
Endobronchial valves have recently emerged as a possible alternative to lung volume reduction surgery to treat incapacitating emphysema. The early experience with placement of these valves has been shown to be safe, with short-term improvements of quality of life in this patient population. We report a case in which these valves were used to treat a patient with a persistent air leak.
- Published
- 2005
199. Persistent air leak - review.
- Author
-
Sakata KK, Reisenauer JS, Kern RM, and Mullon JJ
- Subjects
- Bronchial Fistula complications, Bronchial Fistula pathology, Bronchial Fistula surgery, Bronchoscopy methods, Chest Tubes standards, Fistula complications, Fistula surgery, Humans, Length of Stay statistics & numerical data, Pleural Diseases etiology, Pleural Diseases pathology, Pleurodesis methods, Randomized Controlled Trials as Topic, Septal Occluder Device standards, Thoracostomy standards, Bronchial Fistula diagnostic imaging, Bronchoscopy instrumentation, Fistula diagnostic imaging, Pleural Diseases diagnostic imaging
- Abstract
A persistent air leak (PAL) can be caused by either an alveolar-pleural fistula (APF) or bronchopleural fistula (BPF). Complications from PAL lead to an increase in morbidity and mortality, prolonged hospital stay, and higher resource utilization. Pulmonary physicians and thoracic surgeons are often tasked with the difficult and often times frustrating diagnosis and management of PALs. While most patients will improve with chest tube thoracostomy, many will fail requiring alternative bronchoscopic or surgical strategies. Herein, we review the bronchoscopic and surgical diagnostic and treatment options for PAL as it pertains to the field of interventional pulmonology and thoracic surgery., (Copyright © 2018 Elsevier Ltd. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
200. Endobronchial one-way valves for treatment of persistent air leaks: a systematic review.
- Author
-
Ding M, Gao YD, Zeng XT, Guo Y, and Yang J
- Subjects
- Humans, Lung Diseases diagnostic imaging, Lung Diseases etiology, Pneumothorax diagnostic imaging, Pneumothorax etiology, Pneumothorax surgery, Postoperative Complications diagnostic imaging, Postoperative Complications etiology, Bronchoscopy methods, Endoscopy methods, Lung Diseases surgery, Postoperative Complications surgery
- Abstract
Persistent air leak (PAL) is associated with significant morbidity and mortality, prolonged hospitalization and increased health-care costs. It can arise from a number of conditions, including pneumothorax, necrotizing infection, trauma, malignancies, procedural interventions and complications after thoracic surgery. Numerous therapeutic options, including noninvasive and invasive techniques, are available to treat PALs. Recently, endobronchial one-way valves have been used to treat PAL. We conducted a systematic review based on studies retrieved from PubMed, EMbase and Cochrane library. We also did a hand-search in the bibliographies of relevant articles for additional studies. 34 case reports and 10 case series comprising 208 patients were included in our review. Only 4 patients were children, most of the patients were males. The most common underlying disease was COPD, emphysema and cancer. The most remarkable cause was pneumothorax. The upper lobes were the most frequent locations of air leaks. Complete resolution was gained within less than 24 h in majority of patients. Complications were migration or expectoration of valves, moderate oxygen desaturation and infection of related lung. No death related to endobronchial one-way valves implantation has been found. The use of endobronchial one-way valve adds to the armamentarium for non-invasive treatments of challenging PAL, especially those with difficulties of anesthesia, poor condition and high morbidity. Nevertheless, prospective randomized control trials with large sample should be needed to further evaluate the effects and safety of endobronchial one-way valve implantation in the treatment of PAL.
- Published
- 2017
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.