From the Research
The protocol for an intrapleural blood patch involves collecting 50 mL of the patient's own blood from a peripheral vein and injecting it through an existing chest tube or pleural catheter, followed by elevation of the chest tube for 1-2 hours to allow the blood to distribute in the pleural space and form a seal over the air leak site, as supported by the most recent study 1.
Key Steps in the Protocol
- Collecting 50 mL of the patient's own blood from a peripheral vein using aseptic technique
- Injecting the blood through an existing chest tube or pleural catheter after clamping the tube distal to the injection site
- Elevating the chest tube for 1-2 hours to allow the blood to distribute in the pleural space and form a seal over the air leak site
- Unclamping the chest tube and connecting it to water seal or suction as clinically indicated
Important Considerations
- Patients should be premedicated with analgesics such as 1-2 mg of intravenous morphine or 25-50 mcg of fentanyl to manage discomfort
- Patients should be monitored for fever, chest pain, or signs of infection following the procedure
- The blood patch works by forming a fibrin plug that seals the air leak, as the blood clots and adheres to the pleural surfaces
- This technique is particularly useful for patients who have failed conservative management with prolonged chest tube drainage and are poor surgical candidates, with success rates ranging from 70-90% for persistent air leaks, as reported in 1 and 2