Effectiveness of Dextrose Pleurodesis for the Management of Post-Operative Air Leak

Summary

A common complication following lung resection surgery is the presence of a post-operative air leak. This occurs when the resected lung tissue does not seal adequately, resulting in continued leakage of air from the lung. For most patient, an air leak will self-resolve by maintaining a drainage catheter in the chest for a prolonged period. However, for some patients, additional measures are required to help seal the affected tissue. Known strategies for managing post-operative air leak include placing one-way valves, surgical revision, and chemical pleurodesis. Chemical pleurodesis involves injecting an irritant through the chest drainage catheter to promote sealing of the leaking lung tissue. While many agents exist for chemical pleurodesis, a relatively new method for treating an air leak is by using dextrose solution. Dextrose is appealing due to low cost and availability. Dextrose solution has shown some efficacy in other countries and undergone Phase 1 clinical investigation in Canada to show its safety and dosing recommendations. In this study, our aim is to compare the effectiveness of using dextrose solution for treating post-operative air leak compared to usual care with chest tube drainage alone.

Timeline

Start

2026-06-01

Primary completion

2028-06-30

Completion

2029-06-30

Publications

• Background Qiabi, Mehdi. "PLeurodesis Using hypertonic Glucose administration to treat post-operative air leaks following lung resection surgery (PLUG): Phase I trial." (2021).
• Background Tsukioka T, Inoue K, Oka H, Mizuguchi S, Morita R, Nishiyama N. Pleurodesis with a 50% glucose solution in patients with spontaneous pneumothorax in whom an operation is contraindicated. Ann Thorac Cardiovasc Surg. 2013;19(5):358-63. doi: 10.5761/atcs.oa.12.01986. Epub 2012 Dec 26.
• Background Fujino K, Motooka Y, Koga T, Osumi H, Matsubara E, Shibata H, Ikeda K, Shiraishi K, Mori T, Hayashi K, Yoshimoto K, Wakimoto J, Kubota I, Suzuki M. Novel approach to pleurodesis with 50 % glucose for air leakage after lung resection or pneumothorax. Surg Today. 2016 May;46(5):599-602. doi: 10.1007/s00595-015-1223-2. Epub 2015 Jul 24.
• Background Hong JI, Lee JH, Kim HK. Early Pleurodesis for Postoperative Air Leak with Autologous Blood and 50% Glucose Solution. J Chest Surg. 2023 Jan 5;56(1):16-22. doi: 10.5090/jcs.22.096. Epub 2022 Dec 19.
• Background Mueller MR, Marzluf BA. The anticipation and management of air leaks and residual spaces post lung resection. J Thorac Dis. 2014 Mar;6(3):271-84. doi: 10.3978/j.issn.2072-1439.2013.11.29.
• Background Stephan F, Boucheseiche S, Hollande J, Flahault A, Cheffi A, Bazelly B, Bonnet F. Pulmonary complications following lung resection: a comprehensive analysis of incidence and possible risk factors. Chest. 2000 Nov;118(5):1263-70. doi: 10.1378/chest.118.5.1263.
• Background Elsayed H, McShane J, Shackcloth M. Air leaks following pulmonary resection for lung cancer: is it a patient or surgeon related problem? Ann R Coll Surg Engl. 2012 Sep;94(6):422-7. doi: 10.1308/003588412X13171221592258.
• Background Dugan KC, Laxmanan B, Murgu S, Hogarth DK. Management of Persistent Air Leaks. Chest. 2017 Aug;152(2):417-423. doi: 10.1016/j.chest.2017.02.020. Epub 2017 Mar 4.

Drugs

Indications

No indication recorded.