Autologous Blood Patch Pleurodesis for Persistent Air Leak: A Case Series

Abstract

Autologous blood patch pleurodesis (ABPP) is one of the treatment options for persistent air leak, especially in patients who are not fit for surgical intervention due to poor lung reserve. Herein, we present a series of five cases of persistent air leak treated with ABPP. The mean age of the patients was 35 year old. One patient presented with primary spontaneous pneumothorax, while the other four patients had secondary spontaneous pneumothorax. One patient had active pulmonary tuberculosis infection, and was on anti-tubercular treatment. Three had history of recurrent pneumothorax before ABPP was done. In 4 patients, a trial of negative pressure suctioning was done for 48 hours before ABPP was performed. Four patients were foreigners and could not afford surgical intervention. Two of the cases were unique, as ABPP was performed during pregnancy. They did not achieve full lung re-expansion despite being on intercostal drainage. The other 3 patients had persistent air leak despite having satisfactory apposition of the parietal and visceral pleura on chest X-ray. The average duration of persistent air leak prior to ABPP was 14 days. All five cases of persistent air leak were successfully treated with ABPP with no immediate complication. The mean time to removal of chest drain was 1.5 day after ABPP. In conclusion, ABPP is a safe and feasible treatment option for patients with persistent air leak whereby surgery is not an option, either due to poor lung reserve or cost issues.