Autologous blood patch for persistent air leak in children

J Pediatr Surg. 2013 Sep;48(9):1862-6. doi: 10.1016/j.jpedsurg.2012.12.040.


Purpose: Persistent air leak (PAL) is associated with increased morbidity. Standard treatment of PAL includes chemical or mechanical pleurodesis. Long-term impact of these interventions is not known in the pediatric population. Autologous blood patch (ABP) offers a novel treatment option. We report our experience with autologous blood patch to successfully treat PAL in eight children.

Methods: Children with PAL were treated with ABP. A fresh whole blood sample was obtained from each patient and injected via their pre-existing chest tube. Volume of blood injected, time to cessation of air leak, time to chest tube removal, outcomes and complications were reviewed.

Results: Eight children aged 2 months to 18 years underwent ABP. Three children had immediate seal of air leak, while two patients sealed after 1 and 2 days. Three patients required a second ABP, after which they had immediate seal of air leak. Chest tubes were removed within 2-3 days in 7 cases. One child developed an asymptomatic pneumothorax and required 8 days for radiographic resolution.

Conclusion: ABP appears to be a safe and effective treatment option for PAL in children. ABP offers an inexpensive, easy to perform technique and avoids use of toxic chemicals for pleurodesis in pediatric patients.

Keywords: ABP; Autologous blood patch; PAL; Pediatric; Persistent air leak; autologous blood patch; persistent air leak.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Air
  • Biological Therapy*
  • Biopsy / adverse effects
  • Blood*
  • Chest Tubes / adverse effects
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Injections
  • Lung Diseases / complications
  • Lung Diseases / surgery
  • Male
  • Pneumonectomy
  • Pneumothorax / etiology
  • Pneumothorax / therapy*
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy*
  • Retrospective Studies
  • Thoracic Surgery, Video-Assisted
  • Thoracotomy