041 * POSTOPERATIVE AIR LEAK MANAGEMENT WITH INTRAPLEURAL INSTILLATION OF FRESH FROZEN PLASMA

Abstract

Objectives: Air leak following pulmonary resection is a common complication often leading to prolonged hospitalisation. We aimed to evaluate the efficacy of intrapleurally infused fresh frozen plasma on postoperative air leak management. Methods: Between June 2008 and June 2013, we retrospectively reviewed 81 patients who underwent lobectomy for lung cancer and postoperatively developed prolonged air leak treated with intrapleural instillation of fresh frozen plasma. Results: The study identified 75 men and 6 women, with a median age of 66 years (range 48–76 years), with persistent postoperative air leak, presumed to originate in the interlobar fissure or in the raw lung surface following dissection of adhesions. Infusion of fresh frozen plasma, via the chest tube, was successful in stopping air leaks in 74 patients (91.3%) within 24 h, and in 79 patients (97.5%) within 48 h, following resumption of the procedure. In the remaining two patients, air leak ceased 14 and 19 days later, respectively. There was neither morbidity or mortality associated with the procedure nor relapse of air leak after patient discharge or at follow-up, 1 and 3 months later. Conclusion: Intrapleural infusion of fresh frozen plasma for persistent postoperative air leak management proved to be a safe, inexpensive and remarkably effective method in ceasing postoperative air leak, resulting in prompt patient relief and reduction of hospitalisation.