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Semin Respir Crit Care Med 2001; 22(6): 675-684
DOI: 10.1055/s-2001-18804
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Persistent Air Leaks in Patients Receiving Mechanical Ventilation

Robert R. Kempainen, David J. Pierson
  • Division of Pulmonary and Critical Care Medicine, University of Washington School of Medicine, Seattle, Washington
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Publikationsverlauf

Publikationsdatum:
05. Dezember 2001 (online)

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ABSTRACT

The term bronchopleural fistula (BPF) can be loosely defined as persistent leakage of gas from the airways into the pleural space. A true BPF, however, is located in the central airways, whereas leaks located peripherally are better described by the term parenchymal-pleural fistula (PPF). The presence of a persistent leak in a mechanically ventilated patient is a worrisome prognostic sign independent of the precise origin, yet it is important to distinguish BPF from PPF in this population. Fundamental differences in the pathogenesis and natural history of these two entities dictate divergent approaches to management. This review compares and contrasts the evaluation and management of BPF and PPF in patients receiving mechanical ventilation, and provides an overview of the many nonsurgical interventions used to manage persistent leaks.

KEYWORD

Bronchopleural fistula - persistent air leak - pneumothorax - mechanical ventilation - lung resection - barotrauma - complications

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