पल्मोनरी एवं श्वसन चिकित्सा

Experience of Pleurodesis with a 50% Glucose Solution in Patients with Secondary Pneumothorax: A Case Series

Abstract

Shigehisa Kajikawa

Secondary pneumothorax commonly encountered and it often recurs or becomes a refractory to treatment. Pleurodesis is usually selected for initial treatment in community hospitals. Recently, endobronchial intervention using the endobronchial Watanabe spigot and endobronchial valve for refractory pneumothorax has become available, but these procedures can be performed only at a few institutions with sufficient staff and equipment.

The use of a glucose solution for pleurodesis has been reported as a novel approach to persistent air leakage. Pleurodesis with a 50% glucose solution was occasionally empirically performed in community hospitals. However, only limited literatures have published. Here, I report the experience of five patients (4 men and 1 woman; 71 years to 84 years old), seven times with inoperable secondary pneumothorax who received pleurodesis with a 50% glucose solution. In our cases, two of them had pneumoconiosis, one had chronic obstructive lung disease (COPD), one had interstitial pneumonia (IP) and one had lung cancer. The procedure successfully stopped air leakage and allowed chest tube removal (4 days to 10 days) in three patients without severe complications. Same as previous report, temporary hyperglycemia occurred in three patients. Therefore, pleurodesis with a 50% glucose solution suggested possibility that a feasible and safe. Despite future large-scale studies should aim to examine the efficacy and tolerance of this technique, it would be beneficial to obtain the alternative agent of pleurodesis for patients with inoperable secondary pneumothorax and rural hospitals.