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Eur J Cardiothorac Surg 2004;26:897-900
© 2004 Elsevier Science NL

A prospective study of autologous ‘blood patch’ pleurodesis for persistent air leak after pulmonary resection

Department of Thoracic Surgery, Guy's Hospital, St Thomas Street, London SE1 9RT, UK

Received 27 May 2004; received in revised form 17 July 2004; accepted 23 July 2004.

^* Corresponding author. Tel.: +44-207-188-1038; fax: +44-207-188-1016. (E-mail: loic.lang-lazdunski{at}gstt.nhs.uk).

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 30min and then unclamped and placed back to water seal. Results: We 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 12h 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 50ml of blood is sufficient to seal persistent air leaks in less than 48h. 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.

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