Abstract
Background Autologous blood-patch pleurodesis has been effectively utilized as a treatment option
for the condition of secondary spontaneous pneumothorax (SSP). Moreover, it can be
used with persistent air leak, with or without residual air space. However, there
have been no robust reports for the optimal timing for autologous blood-patch pleurodesis.
The aim of this study is to compare early autologous blood-patch pleurodesis with
conservative management of SSP.
Methods We conducted a randomized controlled study at the Menoufia University Hospital. A
total of 47 patients with SSP were randomly allocated into two groups: group A (23
patients) received intrapleural instillation of 50 mL autologous blood 3 days after
insertion of chest drain and group B (24 patients) managed conservatively. The duration
required for air leak to seal, chest drainage duration, length of hospital stay, and
the incidence of complications were compared and statistically analyzed.
Results The duration of air leak, duration to drain removal, and length of hospital stay
were all significantly shorter in group A than in group B.
Conclusion Early intrapleural instillation of autologous blood is successful in sealing air
leak in patients with SSP with persistent air leak, who are not fit or not willing
to undergo surgery. It is superior to conservative treatment or late instillation
of autologous blood, even if their lungs are not fully expanded.
Keywords
pleura - air leak - effusion - pneumothorax
