Limits...
A Novel Technique to Treat Air Leak Following Lobectomy: Intrapleural Infusion of Plasma.

Konstantinou F, Potaris K, Syrigos KN, Tsipas P, Karagkiouzis G, Konstantinou M - Med. Sci. Monit. (2016)

Bottom Line: Intrapleural infusion of fresh frozen plasma was successful in stopping air leaks in 90 patients (92%) within 24 hours, and in 96 patients (98%) within 48 hours, following resumption of the procedure.In the remaining 2, air leak ceased at 14 and 19 days.CONCLUSIONS Intrapleural infusion of fresh frozen plasma is a safe, inexpensive, and remarkably effective method for treatment of persistent air leak following lobectomy for lung cancer.

View Article: PubMed Central - PubMed

Affiliation: Oncology Unit, 3rd Internal Medicine Clinic of Athens University, Sotiria General Hospital, Athens, Greece.

ABSTRACT
BACKGROUND Persistent air leak following pulmonary lobectomy can be very difficult to treat and results in prolonged hospitalization. We aimed to evaluate the efficacy of a new method of postoperative air leak management using intrapleurally infused fresh frozen plasma via the chest tube. MATERIAL AND METHODS Between June 2008 and June 2014, we retrospectively reviewed 98 consecutive patients who underwent lobectomy for lung cancer and postoperatively developed persistent air leak treated with intrapleural instillation of fresh frozen plasma. RESULTS The study identified 89 men and 9 women, with a median age of 65.5 years (range 48-77 years), with persistent postoperative air leak. Intrapleural infusion of fresh frozen plasma was successful in stopping air leaks in 90 patients (92%) within 24 hours, and in 96 patients (98%) within 48 hours, following resumption of the procedure. In the remaining 2, air leak ceased at 14 and 19 days. CONCLUSIONS Intrapleural infusion of fresh frozen plasma is a safe, inexpensive, and remarkably effective method for treatment of persistent air leak following lobectomy for lung cancer.

No MeSH data available.


Related in: MedlinePlus

Fresh frozen plasma pleurodesis in a patient with persistent postoperative air leak; red (or left) arrows show the IV infusion tubing of the fresh frozen plasma bag and its point of needle penetration of the apical chest tube. B black (or right) arrows show the clamped basal chest tube tubing. Green (or upward) arrows show the extension of the apical chest tube tubing as it passes over the IV pole. Yellow or (downward) arrows show a normal saline solution bottle and its IV infusion tubing hanging over the same pole.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4835152&req=5

f1-medscimonit-22-1258: Fresh frozen plasma pleurodesis in a patient with persistent postoperative air leak; red (or left) arrows show the IV infusion tubing of the fresh frozen plasma bag and its point of needle penetration of the apical chest tube. B black (or right) arrows show the clamped basal chest tube tubing. Green (or upward) arrows show the extension of the apical chest tube tubing as it passes over the IV pole. Yellow or (downward) arrows show a normal saline solution bottle and its IV infusion tubing hanging over the same pole.

Mentions: A total of 98 patients presented with PAAL having the above-mentioned characteristics. On the 6th PO day we added an extension of the chest drain tubing between the apical chest tube and the underwater seal in the drainage device, so that it could be raised above the bed and be suspended over an IV drip stand (green or upward arrows), as shown in Figure 1. Using direct needle penetration of the apical chest tube with the regular IV infusion tubing (red or left arrows) of 1 FFP bag, matched in the ABO group, and hanged from the same IV drip stand, FFP was infused into the pleural cavity within minutes. In this manner, and having clamped the basal chest tube (black or right arrow), FFP was prevented from leaving the pleural space while air was allowed to be evacuated via the apical chest tube. The patient was then advised to remain in bed and to rollover and change positions every 15 minutes for 1 hour so that FFP is distributed evenly into the hemithorax. The following morning (7th PO day), the basal tube was unclamped, the extension tubing of the apical chest tube was taken out, and chest tubes were both connected again directly to their drainage system. When air leak has ceased the basal chest tube was removed in the afternoon so that on the next day (8th PO day) the apical chest tube could be pulled out and the patient could be discharged to home.


A Novel Technique to Treat Air Leak Following Lobectomy: Intrapleural Infusion of Plasma.

Konstantinou F, Potaris K, Syrigos KN, Tsipas P, Karagkiouzis G, Konstantinou M - Med. Sci. Monit. (2016)

Fresh frozen plasma pleurodesis in a patient with persistent postoperative air leak; red (or left) arrows show the IV infusion tubing of the fresh frozen plasma bag and its point of needle penetration of the apical chest tube. B black (or right) arrows show the clamped basal chest tube tubing. Green (or upward) arrows show the extension of the apical chest tube tubing as it passes over the IV pole. Yellow or (downward) arrows show a normal saline solution bottle and its IV infusion tubing hanging over the same pole.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4835152&req=5

f1-medscimonit-22-1258: Fresh frozen plasma pleurodesis in a patient with persistent postoperative air leak; red (or left) arrows show the IV infusion tubing of the fresh frozen plasma bag and its point of needle penetration of the apical chest tube. B black (or right) arrows show the clamped basal chest tube tubing. Green (or upward) arrows show the extension of the apical chest tube tubing as it passes over the IV pole. Yellow or (downward) arrows show a normal saline solution bottle and its IV infusion tubing hanging over the same pole.
Mentions: A total of 98 patients presented with PAAL having the above-mentioned characteristics. On the 6th PO day we added an extension of the chest drain tubing between the apical chest tube and the underwater seal in the drainage device, so that it could be raised above the bed and be suspended over an IV drip stand (green or upward arrows), as shown in Figure 1. Using direct needle penetration of the apical chest tube with the regular IV infusion tubing (red or left arrows) of 1 FFP bag, matched in the ABO group, and hanged from the same IV drip stand, FFP was infused into the pleural cavity within minutes. In this manner, and having clamped the basal chest tube (black or right arrow), FFP was prevented from leaving the pleural space while air was allowed to be evacuated via the apical chest tube. The patient was then advised to remain in bed and to rollover and change positions every 15 minutes for 1 hour so that FFP is distributed evenly into the hemithorax. The following morning (7th PO day), the basal tube was unclamped, the extension tubing of the apical chest tube was taken out, and chest tubes were both connected again directly to their drainage system. When air leak has ceased the basal chest tube was removed in the afternoon so that on the next day (8th PO day) the apical chest tube could be pulled out and the patient could be discharged to home.

Bottom Line: Intrapleural infusion of fresh frozen plasma was successful in stopping air leaks in 90 patients (92%) within 24 hours, and in 96 patients (98%) within 48 hours, following resumption of the procedure.In the remaining 2, air leak ceased at 14 and 19 days.CONCLUSIONS Intrapleural infusion of fresh frozen plasma is a safe, inexpensive, and remarkably effective method for treatment of persistent air leak following lobectomy for lung cancer.

View Article: PubMed Central - PubMed

Affiliation: Oncology Unit, 3rd Internal Medicine Clinic of Athens University, Sotiria General Hospital, Athens, Greece.

ABSTRACT
BACKGROUND Persistent air leak following pulmonary lobectomy can be very difficult to treat and results in prolonged hospitalization. We aimed to evaluate the efficacy of a new method of postoperative air leak management using intrapleurally infused fresh frozen plasma via the chest tube. MATERIAL AND METHODS Between June 2008 and June 2014, we retrospectively reviewed 98 consecutive patients who underwent lobectomy for lung cancer and postoperatively developed persistent air leak treated with intrapleural instillation of fresh frozen plasma. RESULTS The study identified 89 men and 9 women, with a median age of 65.5 years (range 48-77 years), with persistent postoperative air leak. Intrapleural infusion of fresh frozen plasma was successful in stopping air leaks in 90 patients (92%) within 24 hours, and in 96 patients (98%) within 48 hours, following resumption of the procedure. In the remaining 2, air leak ceased at 14 and 19 days. CONCLUSIONS Intrapleural infusion of fresh frozen plasma is a safe, inexpensive, and remarkably effective method for treatment of persistent air leak following lobectomy for lung cancer.

No MeSH data available.


Related in: MedlinePlus