https://doi.org/10.4081/monaldi.2022.2036

Comparison of efficacy of autologous blood patch pleurodesis versus doxycycline pleurodesis in the management of persistent air leak in patients with secondary spontaneous pneumothorax. A randomized controlled trial

http://commons.wikimedia.org/wiki/User:BruceBlaus
Vol. 92 No. 4 (2022)
Submitted: July 29, 2021
Accepted: March 3, 2022
Published: June 10, 2022
Autologous blood patch pleurodiesis, Secondary spontaneous pneumothorax, persistent airleak
Abstract Views: 1949
PDF: 670
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Vijayarangam Narenchandra
Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Govindaraj Vishnukanth
vishnu1429@yahoo.com
https://orcid.org/0000-0002-3854-2388
Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Dharm Prakash Dwivedi
Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Munuswamy Hemachandren
Department of Cardiothoracic and Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Subathra Adithian
Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Saka Vinod Kumar
Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Manju Rajangam
Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Madhusmita Mohanty Mohapatra
Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Pratap Upadhya
Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Secondary spontaneous pneumothorax (SSP) patients sometimes have a persistent air leak (PAL) that leads to increased morbidity and increased hospital stay. Further, these patients also need pleurodesis to prevent a recurrence. Autologous blood patch pleurodesis (ABPP) has been successfully tried in post-lobectomy air leak cases. However, its utility in SSP patients with PAL has not been widely established. In this context, we performed a non-blinded randomized control study to compare the efficacy of ABPP vs doxycycline pleurodesis in the closure of air leak in SSP patients. This study was a non-blinded randomized control study done in 38 SSP patients with PAL. They were randomized into doxycycline arm and ABPP arm. Post pleurodesis air leak was assessed every 12 hours for cessation. Success was considered when there was a complete cessation of air leak. Post-procedural complications were noted and patients were followed up for 28 days to look for recurrence. The median time for closure was 24 hours [interquartile range (12.24)] for ABPP and 36 hours [interquartile range (24.72)] for doxycycline pleurodesis. Success rate of ABPP vs doxycycline pleurodesis is 94.7% vs 84.2% (p=0.6). Post-procedure pain was more in doxycycline group (15% vs 73%) (p<0.01). On visual analogue scale, ABPP had a lesser pain as compared to doxycycline pleurodesis (average visual analogue scale value of 2 vs scale of 7). The recurrence rate was equal in both groups (5%). Though ABPP and doxycycline have similar success rates, ABPP has an early closure of air leak and greater patient tolerability. ABPP can be tried as an alternative to doxycycline pleurodesis in SSP patients with persistent air leaks.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Noppen M, Spontaneous pneumothorax: epidemiology, pathophysiology and cause. Eur Respir Rev 2010;19:117:217–9. DOI: https://doi.org/10.1183/09059180.00005310
Lazarus DR, Casal RF. Persistent air leaks: a review with an emphasis on bronchoscopic management. J Thorac Dis 2017;9:4660–70. DOI: https://doi.org/10.21037/jtd.2017.10.122
Dumire R, Crabbe MM, Mappin FG, Fontenelle LJ. Autologous “blood patch” pleurodesis for persistent pulmonary air leak. Chest 1992;101:64–6. DOI: https://doi.org/10.1378/chest.101.1.64
Shackcloth MJ, Poullis M, Jackson M, Soorae A, Page RD. Intrapleural instillation of autologous blood in the treatment of prolonged air leak after lobectomy: A prospective randomized controlled trial. Ann Thorac Surg 2006;82:1052–6. DOI: https://doi.org/10.1016/j.athoracsur.2006.04.015
Robinson CL. Autologous blood for pleurodesis in recurrent and chronic spontaneous pneumothorax. Can J Surg 1987;30:428–9.
Cagirici U, Sahin B, Cakan A, et al. Autologous blood patch pleurodesis in spontaneous pneumothorax with persistent air leak. Scand Cardiovasc J 1998;32:75–8. DOI: https://doi.org/10.1080/14017439850140210
Martínez-Escobar S, Ruiz-Bailén M, Lorente-Acosta MJ, et al. Pleurodesis using autologous blood: a new concept in the management of persistent air leak in acute respiratory distress syndrome. J Crit Care 2006;21:209–16. DOI: https://doi.org/10.1016/j.jcrc.2005.10.003
Cobanoglu U, Melek M, Edirne Y. Autologous blood pleurodesis: A good choice in patients with persistent air leak. Ann Thorac Med 2009;4:182. DOI: https://doi.org/10.4103/1817-1737.56011
Khan MA, Bhat MA, Majeed A, et al. Intrapleural therapy for the prevention of recurrent spontaneous pneumothorax-A randomized comparative evaluation of bleomycin pleurodesis & autologous blood pleurodesis. Int J Adv Res Ideas Innov Technol 2017:3;955-9.
Heffner JE, Unruh L, Standerfer RJ, Torstveit J. Clinical efficacy of doxycycline for pleurodesis. Chest 1994;105:1743–7. DOI: https://doi.org/10.1378/chest.105.6.1743
Cerfolio RJ. Recent advances in the treatment of air leaks. Curr Opin Pulm Med 2005;11:319–23. DOI: https://doi.org/10.1097/01.mcp.0000161056.85290.08
MacDuff A, Arnold A, Harvey J. Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010.Thorax 2010;65:ii18-ii31. DOI: https://doi.org/10.1136/thx.2010.136986
Onuki T, Ueda S, Yamaoka M, et al. Primary and secondary spontaneous pneumothorax: Prevalence, clinical features, and in-hospital mortality. Can Respir J 2017;2017:6014967. DOI: https://doi.org/10.1155/2017/6014967
Hobbs BD, Foreman MG, Bowler R, et al. Pneumothorax risk factors in smokers with and without chronic obstructive pulmonary disease. Ann Am Thorac Soc 2014;11:1387–94. DOI: https://doi.org/10.1513/AnnalsATS.201405-224OC
Droghetti A, Schiavini A, Muriana P, et al. Autologous blood patch in persistent air leaks after pulmonary resection. J Thorac Cardiovasc Surg 2006;132:556–9. DOI: https://doi.org/10.1016/j.jtcvs.2006.05.033
Abu Arab W, Ramadan A. Spontaneous pneumothorax associated with primary lung cancer: a retrospective study. Cardiothor Surg 2020;28:10. DOI: https://doi.org/10.1186/s43057-020-00020-5
Grosu HB, Vial MR, Hernandez M, et al. Secondary spontaneous pneumothorax in cancer patients. J Thorac Dis 2019;11:1495–505. DOI: https://doi.org/10.21037/jtd.2019.03.35
de Andrade FM, Pereira MR, Kilesse RL, Dos Santos Barnetano B. Autologous blood patch pleurodesis: An effective but underused method. Lung India 2018;35:34142. DOI: https://doi.org/10.4103/lungindia.lungindia_51_18
Iwasawa T, Ogura T, Takahashi H, et al. Pneumothorax and idiopathic pulmonary fibrosis. Jpn J Radiol 2010;28:672–9. DOI: https://doi.org/10.1007/s11604-010-0494-1
Ozpolat B. Autologous blood patch pleurodesis in the management of prolonged air leak. Thorac Cardiovasc Surg 2010;58:52–4. DOI: https://doi.org/10.1055/s-0029-1186200
Chambers A, Routledge T, Billè A, Scarci M. Is blood pleurodesis effective for determining the cessation of persistent air leak? Interact Cardiovasc Thorac Surg 2010;11:468-72. DOI: https://doi.org/10.1510/icvts.2010.234559
Rivas de Andrés JJ, Blanco S, de la Torre M. Postsurgical pleurodesis with autologous blood in patients with persistent air leak. Ann Thorac Surg 2000;1:270-2. DOI: https://doi.org/10.1016/S0003-4975(00)01360-6
Read CA, Reddy VD, O’Mara TE, Richardson MSA. Doxycycline pleurodesis for pneumothorax in patients with AIDS. Chest 1994;105:823–5. DOI: https://doi.org/10.1378/chest.105.3.823
Muruganandan S, Kumar S, Lee YCG. Blood patch for pneumothorax: a literature review. Curr Pulmonol Rep 2017;6:30-8. DOI: https://doi.org/10.1007/s13665-017-0163-2

How to Cite

Narenchandra, Vijayarangam, Govindaraj Vishnukanth, Dharm Prakash Dwivedi, Munuswamy Hemachandren, Subathra Adithian, Saka Vinod Kumar, Manju Rajangam, Madhusmita Mohanty Mohapatra, and Pratap Upadhya. 2022. “Comparison of Efficacy of Autologous Blood Patch Pleurodesis <em>versus< em> Doxycycline Pleurodesis in the Management of Persistent Air Leak in Patients With Secondary Spontaneous Pneumothorax. A Randomized Controlled Trial”. Monaldi Archives for Chest Disease 92 (4). https://doi.org/10.4081/monaldi.2022.2036.
Copyright (c) 2022 The Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.


Similar Articles

<< < 1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.