Early use of autologous blood patch pleurodesis in children is successful in resolving persistent air leaks

Purpose: Experience with autologous blood patch (ABP) pleurodesis for persistent air leak in the pediatric population is limited. The purpose of this series was to describe the experience with ABP at a single tertiary children's hospital.

Methods: A retrospective study was performed of all thoracic procedures done by the pediatric surgery service over three years.

Results: Ten patients underwent a total of 17 ABPs. The median age of patients was 12 years (IQR 6-16). The most common underlying reasons for a thoracic procedure included: blebectomy for spontaneous pneumothorax (2), need for lung biopsy (2), resection of known malignant tumor (2), and empyema (2). The median number of days of persistent air leak before first ABP was 7.5 days (IQR 7-10). A second ABP was performed in 6 cases with a third procedure performed in one case. None of the patients developed respiratory compromise during ABP and no infectious complications were identified following ABP.

Conclusions: Our cohort demonstrates that ABP for persistent air leak following thoracic surgery is effective with minimal morbidity in children. We believe ABP can be used early and in patients with a broad range of underlying lung pathology.