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中华胸部外科电子杂志

中华胸部外科电子杂志 ›› 2021, Vol. 08 ›› Issue (02) : 89 -94. doi: 10.3877/cma.j.issn.2095-8773.2021.02.03

所属专题： 文献；

国际胸外科专栏

Bronchoscopic management of persistent air leaks
Elliot Ho1,†(), Joslyn Vo2, Ajay Wagh1, Douglas Kyle Hogarth1   
  1. 1. Section of Pulmonary and Critical Care Medicine/Interventional Pulmonology, Department of Medicine, The University of Chicago, Chicago, IL, USA
    2. Section of Pulmonary and Critical Care Medicine, Department of Medicine, Loma Linda University, Loma Linda, CA, USA
  • 收稿日期:2021-05-04 接受日期:2021-05-17 出版日期:2021-05-28
  • 通信作者: Elliot Ho

Bronchoscopic management of persistent air leaks

Elliot Ho1(), Joslyn Vo2, Ajay Wagh1, Douglas Kyle Hogarth1   

  1. 1. Section of Pulmonary and Critical Care Medicine/Interventional Pulmonology, Department of Medicine, The University of Chicago, Chicago, IL, USA
    2. Section of Pulmonary and Critical Care Medicine, Department of Medicine, Loma Linda University, Loma Linda, CA, USA
  • Received:2021-05-04 Accepted:2021-05-17 Published:2021-05-28
  • Corresponding author: Elliot Ho
  • About author:
    Contributions: (I) Conception and design: All authors; (II) Administrative support: All authors; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: None; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Cite this article as: Ho E, Vo J, Wagh A, Hogarth DK. Bronchoscopic management of persistent air leaks. Chin J Thorac Surg (Electronic Edition) 2021;8(2):89-94.
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Elliot Ho, Joslyn Vo, Ajay Wagh, Douglas Kyle Hogarth. Bronchoscopic management of persistent air leaks[J]. 中华胸部外科电子杂志, 2021, 08(02): 89-94.

Elliot Ho, Joslyn Vo, Ajay Wagh, Douglas Kyle Hogarth. Bronchoscopic management of persistent air leaks[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2021, 08(02): 89-94.

Air leaks can occur as a complication of thoracic surgery, bronchoscopic procedures, or from barotrauma due to mechanical ventilation. Persistent air leaks defined as air leaks that last longer than 5-7 days are often associated with prolonged hospital stay, higher rates of intensive care unit admission, and a significant source of morbidity and mortality. Surgical repair of persistent air leaks via thoracotomy or video-assisted thorascopic surgery generally has excellent success. However, for patients with severe hypoxemia, poor functional status, or significant comorbidities, surgical repair may not be feasible. The use of bronchoscopic interventions such as the delivery of coils, covered airway stents, endobronchial valves, biological sealants, and other devices to safely and effectively manage persistent air leaks has been widely reported in recent years. Bronchoscopic intervention of persistent air leak has a reported success rate of closure ranging from 30-80% depending on the underlying disease, location, and size of the pleural fistula. It is an excellent option for patients with persistent air leak who are critically ill and are poor surgical candidates. Advantages of using endobronchial devices include quick recovery time, relatively low risk, reduction in hospital stay, and the potential for immediate symptom relief. Here, we review the data regarding the use of bronchoscopic techniques in the management of persistent air leak.

关键词: bronchoscopy, persistent air leak, endobronchial valve, pneumothorax

Air leaks can occur as a complication of thoracic surgery, bronchoscopic procedures, or from barotrauma due to mechanical ventilation. Persistent air leaks defined as air leaks that last longer than 5-7 days are often associated with prolonged hospital stay, higher rates of intensive care unit admission, and a significant source of morbidity and mortality. Surgical repair of persistent air leaks via thoracotomy or video-assisted thorascopic surgery generally has excellent success. However, for patients with severe hypoxemia, poor functional status, or significant comorbidities, surgical repair may not be feasible. The use of bronchoscopic interventions such as the delivery of coils, covered airway stents, endobronchial valves, biological sealants, and other devices to safely and effectively manage persistent air leaks has been widely reported in recent years. Bronchoscopic intervention of persistent air leak has a reported success rate of closure ranging from 30-80% depending on the underlying disease, location, and size of the pleural fistula. It is an excellent option for patients with persistent air leak who are critically ill and are poor surgical candidates. Advantages of using endobronchial devices include quick recovery time, relatively low risk, reduction in hospital stay, and the potential for immediate symptom relief. Here, we review the data regarding the use of bronchoscopic techniques in the management of persistent air leak.

Key words: bronchoscopy, persistent air leak, endobronchial valve, pneumothorax
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