Abstract:

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