Digital measurement and prognostic effect of air leak on thoracic surgery patients who followed by tube thoracostomy

Prolonged air leak (PAL) is a morbidly encountered in patients who have undergone tube thoracostomy due to spontaneous pneumothorax or who are undergoing pulmonary resection. In primary spontaneous pneumothorax cases, air leak drainage which is longer than 5-7 days is accepted as PAL and is an indication for surgical treatment. PAL requires additional interventions in postoperative patients, ranging from pleurodesis to reoperation. The early recognition of PAL with the cause of these important features can provide many advantages in sickness. In our prospective study; We measure patients' air leaks with the help of a sensitive anemometer and a mobile phone with android processor. Group-1 patients underwent tube thoracostomy due to spontaneous pneumothorax and Group-2 patients underwent lung resection. We have standardized the study by applying strict rules in patient selection and measurement procedures. We evaluated the cut-off values for the relationship between the peak current values measured during the day and the development of PAL and the peak leakage current by ROC analysis. We have shown that in both Group-1 and Group-2 patients, we can detect PAL growth with sensitivity and specificity above 90%, only with peak leak volume measurement. Using the results, we found that patients with spontaneous pneumothorax could be measured only by air leakage and that surgical decision could be taken without waiting for 5-7 days. In postoperative cases, we have shown that air leaks over a certain amount will persist and additional surgical procedures such as blood-patch pleurodesis, retoracotomy will be needed. We also emphasized that additional treatment can be performed in this patient group without waiting for 5-7 days. In our study, additional results were obtained regarding blood-patch pleurodesis (BP) activity. Positive results were obtained with BP pleurodesis applied to patients with peak air leak value of 250 mL / sec. We believe that our work will be supported by similar studies to gain new prognostic parameters such as peak leak volume, peak air leak to literature.