Objective: Pleurodesis using chemical agents has been
applied to high-risk patients with pneumothorax. This treatment,
however, is sometimes unsuccessful in patients with intractable
pneumothorax or intrapleural dead space. We developed a technique for
the intrapleural administration of diluted fibrin glue as a
treatment for such patients.
Methods: Fibrin glue was
diluted fourfold with saline solution and/or contrast medium.
Pleurodesis with a large amount of the diluted fibrin glue was
performed in 40 high-risk patients with intractable pneumothorax and in
13 postthoracotomy patients with persistent air leakage associated with
an intrapleural dead space.
Results: The air leaks
were stopped by administration of the glue in all patients of both
groups. During the follow-up period, a recurrence rate of 12.5% was
observed in the former group. These recurrent pneumothoraces also were
successfully treated by glue administration with no further recurrence.
In the 13 postthoracotomy patients, there was no recurrence after the
initial treatment. Pyrexia (12.5%) and chest discomfort (4.1%) were
observed as side effects, but there were no findings of severe chest
pain or thoracic empyema.
Conclusions: These results
suggest that intrapleural administration of a large amount of diluted
fibrin glue is a useful treatment for intractable pneumothoraces in
high-risk or postthoracotomy patients who have an intrapleural dead