Management of persistent air leak in Neonates: A case series
Keywords:Autologous blood patch pleurodesis (ABPP), Persistent air leak (PAL), Neonate, Chest tube
Background: Autologous blood patch pleurodesis (ABPP) has been used in adults as an efficient and safe technique to address persistent air leak (PAL). A fibrin glue patch is also an alternative, but its elevated cost and technique can limit its routine use. Evidence of their use in the pediatric population, specifically in the neonatal age is scant.
Case Presentation: We share our management experience in a series of 3 cases. The first 2 were treated exclusively with ABPP and showed clinical and radiographic improvement. The 3rd case, due to the persistence of the air leak, required extended thoracotomy and fibrin patch placement.
Conclusion: The use of ABPP as an alternative for the treatment of neonates with PAL is a safe and efficient technique. The procedure is replicable and can be done at the bedside at a low cost. A fibrin glue patch should be considered as an alternative option when ABPP fails to resolve the leak.
Sahn S, Heffner J. Spontaneous pneumothorax. N Engl J Med. 2000; 342:868–74.
Cerfolio RJ, Bryant AS. The management of chest tubes after pulmonary resection. Thoracic Surgery Clinics. 2010; 20:399-405.
Lillegard JB, Kennedy RD, Ishitani MB, Zarroug AE, Feltis B. Autologous blood patch for persistent air leak in children. J Pediatr Surg. 2013; 48:1862-6.
Lackey A, Mitchell JD. The cost of air leak: Physicians’ and Patients’ perspectives. Thor Surg Clin. 2010; 20:407-11.
Cobanoglu U, Melek M, Edirne Y. Autologous blood pleurodesis: A good choice in patients with persistent air leak. Ann Thorac Med. 2009; 4:182–6.
Huseynov M. A first case report of neonatal persistent pneumothorax treated with an autologous blood patch. Turkish Arch Pediatr. 2020; 55:438–40.
Rinaldi S, Felton T, Bentley A. Blood pleurodesis for the medical management of pneumothorax. Thorax. 2009; 64:258–60.
Dumire R, Crabbe MM, Mappin FG, Fontenelle LJ. Autologous “blood patch” pleurodesis for persistent pulmonary air leak. Chest. 1992; 101:64–6.
Manley K, Coonar A, Wells F, Scarci M. Blood patch for persistent air leak: A review of the current literature. Opin Pulm Med. 2012; 18:333–8.
Tatewaki H, Nakano T, Hinokiyama K, Ebuoka N, Matsumae H, Machida D. Successful treatment for prolonged air leaks with an autologous “blood patch” pleurodesis after the Norwood procedure. Jpn J Cardiovasc Surg. 2014; 43:340–3.
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Copyright (c) 2023 Jimmy Israel Andrade- Montesdeoca, Vicente Salinas- Salinas, Daniel Acosta- Farina, Daniel Acosta- Bowen
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