Bronchoscopic Valve Management of Persistent Air‐Leaks in Mechanically Ventilated Patients

Abstract

ABSTRACT Management of persistent air‐leaks (PAL) in mechanically ventilated patients is challenging as most patients are refractory to standard treatments. Herein, we report the successful management of persistent air‐leaks in a case series of seven patients. Patients were mechanically ventilated and presented severe air‐leaks that persisted 17.5 ± 6.2 days after chest drainage insertion. Patients were deemed unfit for surgical resection while talc pleurodesis was unfeasible in five patients or performed without success in two. Valves treatment was performed at bedside in the Intensive Care Unit. Chest drainage was removed 5.5 ± 3.1 days after valve insertion, and all patients were weaned off the ventilator 8.8 ± 3.4 days later. All but one patient was discharged 26.8 ± 10.2 days following the procedure. One patient died at 35 days due to systemic sepsis not related to valves. Valves were readily removed in four patients at a mean of 149 ± 12.7 days after the implant. Our study confirmed the safe and effective use of EBV treatment for the management of PAL refractory to standard treatment in mechanically ventilated patients.

Keywords

• air‐leaks
• bronchoscopy
• endobronchial valve
• ventilated patients