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
Submitted: July 29, 2021
Accepted: March 3, 2022
Published: June 10, 2022
Accepted: March 3, 2022
Abstract Views: 1949
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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
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.
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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.
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