CHEST 2023 On Demand Pass-Stuck on Suction! The Dilemma of the Persistent Air Leak

Video Transcription

Video Summary

Persistent air leaks can occur after surgery or spontaneously and can be challenging to manage. Conservative management, such as observation and chest tube drainage, is often successful, but for cases where the air leak persists, other treatment options can be considered. One option is autologous blood patch, where the patient's own blood is instilled into the pleural space to seal the leak. This has shown good success rates, particularly in postoperative air leaks. Another option is endobronchial therapy, which includes the use of one-way bronchial valves or endobronchial blockers to block the airway leading to the leak. These therapies have shown success rates in reducing or stopping the air leak, particularly in postoperative cases. Chemical pleurodesis, where a sclerosing agent is introduced into the pleural space, can also be considered, but its success rates are varied. Surgical management may be necessary for cases where other treatment options are ineffective. This can include vats or open surgery to address the underlying cause of the air leak, such as repairing a bronchopleural fistula or reinforcing the staple line. Other intraoperative techniques, such as buttressing the staple line or using sealants, can also help prevent persistent air leaks. Overall, the choice of treatment depends on various factors, including the underlying cause of the air leak, its duration, and the patient's overall condition.

Meta Tag

Category Disorders of the Pleura

Session ID 1113

Speaker Lakshmi Mudambi

Speaker Philip Ong

Speaker Joseph Thachuthara-George

Speaker Peter Tsai

Track Disorders of the Pleura

Keywords

persistent air leaks

conservative management

autologous blood patch

endobronchial therapy

chemical pleurodesis

surgical management

bronchopleural fistula

reinforcing the staple line

patient's condition