• Am. J. Med. Sci. · Dec 2022

    Review

    Pressure-dependent persistent air leak in a patient with Secondary Spontaneous Pneumothorax.

    • Biplab K Saha, Woon Hean Chong, Kurt Hu, Santu Saha, Alyssa Bonnier, and Praveen Chenna.
    • Department of Pulmonary and Critical Care Medicine, Ozarks Medical Center, West Plains, MO, United States. Electronic address: spanophiliac@yahoo.com.
    • Am. J. Med. Sci. 2022 Dec 1; 364 (6): 782788782-788.

    AbstractAn air leak lasting more than 5-7 days (persistent air leak, PAL) can complicate up to 40% of patients with secondary spontaneous pneumothorax. Chronic obstructive pulmonary disease is the most common cause of secondary spontaneous pneumothorax, and early surgical intervention has been recommended for patients with PAL. Bullectomy or blebectomy with concomitant mechanical pleurodesis by medical thoracoscopy or video assisted thoracoscopic surgery is considered definitive therapy. Unfortunately, the perioperative course following lung resection can also be complicated by air leaks leading to worse clinical outcomes. Post lung resection air leak can be pressure independent or pressure dependent (also known as drainage-related air leak). The distinction between these two entities is crucial as the management varies drastically. Pleural manometry may play an important role in the early diagnosis of pressure-dependent PAL preventing further unnecessary surgical procedures from being performed.Copyright © 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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