Journal of Critical Care
Volume 25, Issue 1 , Pages 47-55 , March 2010

Bronchopleural fistula: An update for intensivists

  • Kiran Shekar, MBBS

      Affiliations

    • Critical Care Research Group, The Prince Charles Hospital, Chermside 4032, Queensland, Australia
    • Corresponding Author InformationCorresponding author. Mcdowall 4053, Queensland, Australia. Tel.: +61 733536978, +61 411294763.
  • ,
  • Carole Foot, MBBS, FACEM, FJFICM

      Affiliations

    • Royal North shore Hospital, Sydney, Australia
  • ,
  • John Fraser, MBChB, MRCP, FRCA, FFARCSI, FJFICM

      Affiliations

    • Critical Care Research Group, The Prince Charles Hospital, Chermside 4032, Queensland, Australia
  • ,
  • Marc Ziegenfuss, MB BCH, FJFICM

      Affiliations

    • The Prince Charles Hospital, Chermside 4032, Queensland, Australia
  • ,
  • Peter Hopkins, MBBS, FRACP

      Affiliations

    • The Prince Charles Hospital, Chermside 4032, Queensland, Australia
  • ,
  • Morgan Windsor, MBBS, FRACS

      Affiliations

    • The Prince Charles Hospital, Chermside 4032, Queensland, Australia

References 

  1. Takaoka K, Inoue S, Ohira S. Central bronchopleural fistulas closed by bronchoscopic injection of absolute ethanol. Chest. 2002;122:374–378
  2. Asamura H, Kondo H, Tsuchiya R. Management of the bronchial stump in pulmonary resections: a review of 533 consecutive recent bronchial closures. Eur J Cardiothorac Surg. 2000;17:106–110
  3. Baumann WR, Ulmer JL, Ambrose PG, Garvey MJ, Jones DT. Closure of a bronchopleural fistula using decalcified human spongiosa and a fibrin sealant. Ann Thorac surg. 1997;64:230–233
  4. Cerfolio RJ. The incidence, etiology and prevention of postresectional bronchopleural fistula. Semin Thorac Cardiovasc surg. 2001;13:3–7
  5. Lois M, Noppen M. Bronchopleural fistulas: an overview of the problem with special focus on endoscopic management. Chest. 2005;128:3955–3965
  6. Sato M, Saito Y, Fujimura S, et al. Study of Postoperative bronchopleural fistulas—analysis of factors related to bronchopleural fistulas. Nippon Kyobu Geka Gakkai Zasshi. 1989;37:498–503
  7. Frytak S, Lee RE, Pairolero PC, Arnold PG, Shaw JN. Necrotic lung and bronchopleural fistula as complications of therapy in lung cancer. Cancer Invest. 1988;6:139–143
  8. Hankins JR, Miller JE, Attar S, Satterfield JR, McLaughlin JS. Bronchopleural fistula, thirteen year experience with 77 cases. J Thorac Cardiovasc Surg. 1978;76:755–762
  9. Steiger Z, Wilson RF. Management of bronchopleural fistulas. Surg Gynecol Obstet. 1984;158:267–271
  10. Pierson DJ, Horton CA, Bates PW. Persistent bronchopleural air leak during mechanical ventilation. A review of 39 cases. Chest. 1986;90:321–323
  11. Donath J, Khan FA. Tuberculosis and posttuberculous bronchopleural fistula. Ten year clinical experience. Chest. 1984;86:697–703
  12. JE McManigle GL, Fletcher MF. Tenholder. Bronchoscopy in the management of bronchopleural fistula. Chest. 1990;97:1235–1238
  13. Baumann MH, Sahn SA. Medical management and therapy of bronchopleural fistulas in mechanically ventilated patient. Chest. 1990;97:721–728
  14. Torre M, Chiesa G, Ravini M, Vercelloni M, Belloni PA. Endoscopic gluing of bronchopleural fistula. Ann Thorac Surg. 1987;43:295–297
  15. Darling GE, Abdurahman A, Yi QL, et al. Risk of a right pneumonectomy: role of bronchopleural fistula. Ann Thorac Surg. 2005;79:433–437
  16. Hsu JT, Bennett GM, Wolff E. Radiologic assessment of bronchopleural fistula with empyema. Radiology. 1972;103:41–45
  17. Wong DC, Haindl W. The use of Technegas in the detection of a bronchopleural fistula. Clin Nucl Med. 2000;25:548–549
  18. Alifano M, Sepulveda S, Mulot A, Schussler O, Regnard JF. A new method for detection of postpnemonetomy broncho-pleural fistulas. Ann Thorac Surg. 2003;75:1662–1664
  19. Ricci ZJ, Haramati LB, Rosembaum AT, Liebling MS. Role of computed tomography in guiding the management of peripheral bronchopleural fistula. J thorac Imaging. 2002;17:214–218
  20. Westcott JL, Volpe JP. Peripheral bronchopleural fistula: CT evaluation in 20 patients with pneumonia, empyema, or postoperative air leak. Radiology. 1995;196:175–181
  21. Rusch VW, Capps JS, Tyler ML, Pierson DJ. The performance of four pleural drainage systems in an animal model of bronchopleural fistula. Chest. 1988;93:859–863
  22. Batchelder TL, Morris KA. Critical factors in determining adequate pleural drainage in both the operated and nonoperated chest. Am Surg. 1962;28:296–302
  23. Powner DJ, Cline D, Rodman GH. Effect of chest tube suction on gas flow through a bronchopleural fistula. Critical Care Medicine. 1985;13:99–101
  24. Larson RP, Capps JS, Pierson DJ. A comparison of three devices used for quantitating bronchopleural air leak. Respir Care. 1986;31:1065
  25. Downs JB, Chapman RL. Treatment of bronchopleural fistula during continuous positive pressure ventilation. Chest. 1976;69:363–366
  26. Phillips YY, Lonigan RM, Joyner LR. A simple technique for managing a bronchopleural fistula while maintaining positive pressure ventilation. Crit Care Med. 1979;7:351–353
  27. Gallagher TJ, Smith RA, Kirby RR, Civetta JM. Intermittent inspiratory chest tube occlusion to limit bronchopleural cutaneous leaks. Crit Care Med. 1976;4:328–332
  28. Bevelaqua FA, Kay S. A modified technique for the management of bronchopleural fistula in ventilator dependent patients: a report of two cases. Respir Care. 1986;31:904–908
  29. Roth MD, Wright JW, Bellamy PE. Gas flows through a bronchopleural fistula. Measuring the effects of high-frequency jet ventilation and chest tube suction. Chest. 1988;93:210–213
  30. Zimmerman JE, Colgan DL, Mills M. Management of bronchopleural fistula complicating therapy with positive end expiratory pressure. Chest. 1973;64:526–529
  31. Ventilator auto-triggering in a patient with tuberculous bronchopleural fistula. Respir Care. 2003;48:5
  32. Goldszer RC, Bennett J, VanCampen J, Rudnitzky J. Intrapleural Tetracycline for spontaneous pneumothorax. JAMA. 1979;241:724–725
  33. Macoviak JA, Stephenson LW, Ochs R, Edmunds LH. Tetracycline pleurodesis during active pulmonary-pleural air leak for prevention of recurrent pneumothorax. Chest. 1982;81:78–81
  34. Baumann MH, Praful BP, Chris WR, Marcy FP. Comparison of function of commercially available pleural drainage units and catheters. Chest. 2003;123:1278–1286
  35. Powner DJ, Grenvik A. Ventilatory management of life threatening bronchopleural fistulae. A summary. Crit Care Med. 1981;9:54–58
  36. Dennis JW, Eigen H, Ballantine TV, Grosfeld JL. The relationship between peak inspiratory pressure and positive end expiratory pressure on the volume of air lost through bronchopleural fistula. J Pediatr Surg. 1980;15:971–976
  37. Litmanovitch M, Joynt GM, Cooper PJ, Kraus P. Persistent bronchopleural fistula in a patient with adult respiratory distress syndrome. Treatment with pressure controlled ventilation. Chest. 1993;104:1901–1902
  38. Ost D, Corbridge T. Independent lung ventilation. Clin Chest Med. 1996;17:591–601
  39. Doyle DJ. Bronchial blockade to improve alveolar ventilation. Can J Anaesth. 1993;40:1223–1224
  40. Inoue H, Shohtsu A, Ogawa J, Kawada S, Koide S. New device for one-lung anesthesia: endotracheal tube with movable blocker. J Thorac Cardiovasc Surg. 1982;83:940–941
  41. Bauer C, Winter C, Hentz JG, Ducrocq X, Steib A, Dupeyron JP. Bronchial blocker compared to double-lumen tube for one lung ventilation during thoracoscopy. Acta Anaesthesiol Scand. 2001;45:250–254
  42. Benumof JL, Partridge BL, Salvatierra C, Keating J. Margin of safety in positioning modern double-lumen endotracheal tubes. Anesthesiology. 1987;67:729–738
  43. Brodsky JB. Fibreotic bronchoscopy need not be a routine part of double-lumen tube placement. Curr Opin Anaesthesiol. 2004;17:7–11
  44. Smith GB, Hirsch NP, Ehrenwerth J. Placement of double lumen endotracheal tubes. Correlation between clinical impressions and bronchoscopic findings. Br J Anaesth. 1986;58:1317–1320
  45. Anatham D, Jagadesan R, Tiew PEC. Clinical review; independent lung ventilation in critical care. Crit Care. 2005;9:594–600
  46. Dodds CP, Hillman KM. Management of massive air leak with asynchronous independent lung ventilation. Intensive Care Med. 1982;8:287–290
  47. Crimi G, Candiani A, Conti G, Mattia C, Gasparetto A. Clinical applications of Independent lung ventilation with unilateral high-frequency jet ventilation. Intensive Care Med. 1986;12:90–94
  48. Feeley TW, Keating D, Nishimura T. Independent lung ventilation using high-frequency ventilation in the management of bronchopleural fistula. Anesthesiology. 1988;69:420–422
  49. Carvalho P, Thompson WH, Riggs R, Carvalho C, Charan NB. Management of bronchopleural fistula with a variable resistance valve and a single ventilator. Chest. 1997;111:1452–1454
  50. Shekar K, Foot CL, Fraser JF. Independent lung ventilation in the intensive care unit: desperate measure or viable treatment option. Cric Care Resusc. 2008 Jun;10(2):148
  51. Cinnella G, Dambrosio M, Brienza N, et al. Independent lung ventilation in patients with unilateral lung contusion. Monitoring with compliance and EtCO2. Intensive Care Med. 2001;27:1860–1867
  52. Smith RB. Ventilation at high respiratory frequencies. High frequency positive pressure ventilation, high frequency jet ventilation and high frequency oscillation. Anaesthesia. 1982;37:1011–1018
  53. Ha DV, Johnson D. High frequency oscillatory ventilation in the management of a high output bronchopleural fistula: a case report. Can J Anaesth. 2004;51:78–83
  54. Bishop MJ, Benson MS, Sato P, Pierson DJ. Comparison of high-frequency jet ventilation with conventional mechanical ventilation for bronchopleural fistula. Anesth Analg. 1987;66:833–838
  55. Campbell D, Stienmann M, Porayko L. Nitric oxide and high frequency jet ventilation in a patient with bilateral bronchopleural fistula and ARDS. Can J Anaesth. 2000;47:53–57
  56. Mortimer AJ, Laurie PS, Garret H, Kerr JH. Unilateral high frequency jet ventilation. Reduction of leak in bronchopleural fistula. Intensive Care Med. 1984;10:39–41
  57. Orlando R, Gluck EH, Cohen M, Mesologites CG. Ultra-high-frequency jet ventilation in a bronchopleural fistula model. Arch Surg. 1988;123:591–593
  58. David M, Werner C. High frequency oscillatory ventilation: ventilation procedure for adults with lung failure. Anaesthesist. 2007;21:[electronic publication]
  59. Rubio JJ, Algora-Weber A, Dominguez-de Villota E, Chamorro C, Mosquera JM. Prolonged high-frequency jet ventilation in a patient with bronchopleural fistula. An alternative mode of ventilation. Intensive Care Med. 1986;12:161–163
  60. Shen NH, Lu FL, Wu HD, Yu CJ, Yang PC. Management of tension pneumatocele with high-frequency oscillatory ventilation. Chest. 2002;121:284–286
  61. Harry LA, Arnold GC, David JS, et al. Extracorporeal life support (ECLS) for pediatric trauma: experience with 5 cases. Pediatr Surg Int. 1990;5:302–306
  62. Metabolic measurement using indirect calorimetry during mechanical ventilation. 2004 revision and update. Respir Care. 2004;49:1073–1079
  63. Bishop MJ, Benson MS, Pierson DJ. Carbon dioxide excretion via bronchopleural fistulas in adult respiratory distress syndrome. Chest. 1987;91:400–402
  64. Puskas JD, Mathisen DJ, Grillo HC, Wain JC, Wright CD, Moncure AC. Treatment strategies for bronchopleural fistula. J Thorac Cardiovasc Surg. 1995;109:989–996
  65. Pairolero PC, Arnold PG, Trastek VF, Meland NB, Kay PP. Pneumonectomy empyema: the role of intrathoracic muscle transposition. J Thorac Cardiovasc Surg. 1990;99:958–968
  66. Weber J, Grabner D, al-Zand K, Beyer D. Empyema after pneumonectomy—empyema window or thoracoplasty?. Thorac Cardiovasc Surg. 1990;38:355–358
  67. Clagett OT, Geraci JE. A procedure for the management of postpneumonectomy empyema. J Thorac Cardiovasc Surg. 1963;45:141–145
  68. Utley JR. Completion pneumonectomy and thoracoplasty for bronchopleural fistula and fungal empyema. Ann Thorac Surg. 1993;55:672–676
  69. Lin J, Iannettoni MD. Closure of bronchopleural fistulas using albumin-glutaraldehyde tissue adhesive. Ann Thorac Surg. 2004;77:326–328
  70. Hollaus PH, Lax F, Wuring PN, Janakiev D, Pridun NS. Videothoracoscopic debridement of the postpneumonectomy space in empyema. Eur J Cardiothorac Surg. 1999;16:283–286
  71. Stamatis G, Martini G, Freitag L, Wencker M, Greschuchna D. Transsternal transpericardial operations in the treatment of bronchopleural fistulae after pneumonectomy. Eur J Cardiothorac Surg. 1996;10:83–86
  72. de la Riviere AB, Defauw JJ, Knaepen PJ, Van Swieten HA, Vanderschueren RC, Van den Bosch JM. Transsternal closure of bronchopleural fistula after pneumonectomy. Ann Thorac Surg. 1997;64:954–957
  73. Ratliff JL, Hill JD, Tucker H, Fallat R. Endobronchial control of bronchopleural fistulae. Chest. 1977;71:98–99
  74. Hartmann W, Rausch V. New therapeutic application of the fiberoptic bronchoscope. Chest. 1977;71:237
  75. Hoier-Madsen K, Schulze S, Moller Pederson V, Halkier E. Management of bronchopleural fistula following pneumonectomy. Scand J Thorac Cardiovasc Surg. 1984;18:263–266
  76. Jessen C, Sharma P. Use of fibrin glue in thoracic surgery. Ann Thorac Surg. 1985;39:521–524
  77. Onotera RT, Unruh HW. Closure of a post-pneumonectomy bronchopleural fistula with fibrin sealant (Tisseel). Thorax. 1988;43:1015–1016
  78. Glover W, Chavis TV, Daniel TM, Kron L, Spotnitz WD. Fibrin glue application through the flexible fibreoptic bronchoscope: closure of bronchopleural fistulas. J Thorac Cardiovasc Surg. 1987;93:470–472
  79. Menard JW, Prejean CA, Tucker WY. Endoscopic closure of bronchopleural fistula using a tissue adhesive. Am J Surg. 1988;155:415–416
  80. Jones DP, David I. Gelfoam occlusion of peripheral bronchopleural fistulas. Ann Thorac Surg. 1986;42:334–335
  81. Lan RS, Lee CH, Tsai YH, Wang WJ, Chang CH. Fibreoptic bronchial blockade in a small bronchopleural fistula. Chest. 1987;92:944–946
  82. Ellis JH, Sequeira FW, Weber TR, Eigen H, Fitzgerald JF. Balloon catheter occlusion of bronchopleural fistulae. AJR Am J Roentgenol. 1982;138:157–159
  83. Tao H, Araki M, Sato T, et al. Bronchoscopic treatment of postpneumonectomy bronchopleural fistula with a collagen screw plug. J Thorac Cardiovasc Surg. 2006;132:99–104
  84. Ponn RB, D’Agostino RS, Stern H, Westcott JL. Treatment of peripheral bronchopleural fistulas with endobronchial occlusion coils. Ann Thorac Surg. 1993;56:1343–1347
  85. Islam SU, Beamis JF, Choi IS. Successful closure of a bronchopleural fistula with platinum vascular occlusion coils and N-butyl-cyanoacrylate glue. Chest. 2003;124:292S–293S
  86. Ferguson JS, Sprenger K, Van Natta T. Closure of a bronchopleural fistula using bronchoscopic placement of an endobronchial valve designed for the treatment of emphysema. Chest. 2006;129:479–481
  87. Feller-Kopman D, Bechara R, Garland R, Ernst A, Ashiku S. Use of removable endobronchial valve for the treatment of bronchopleural fistula. Chest. 2006;130:273–275
  88. Wang KP, Schaeffer L, Heitmiller R, Baker R. Nd:YAG laser closure of a bronchopleural fistula. Monaldi Arch Chest Dis. 1993;48:301–303
  89. Kiriyama M, Fujii Y, Yamakawa Y, et al. Endobronchial neodymium: yttrium-aluminum garnet laser for noninvasive closure of small proximal bronchopleural fistula after lung resection. Ann Thorac Surg. 2002;73:945–948

PII: S0883-9441(09)00118-X

doi: 10.1016/j.jcrc.2009.05.007

Journal of Critical Care
Volume 25, Issue 1 , Pages 47-55 , March 2010