Air Leaks
Persistent airleaks are a significant problem and can result in considerable morbidity, prolonged hospital stay and increased health care costs. Airleaks occur after 15% of thoracic operations. Causes include trauma, other pulmonary diseases, and spontaneous pneumothoraces. When an air leak is present on the 4th postoperative day, the chance of the air leak continuing into day 7 is 83%3. If treatment with a chest drain does not resolve the air leak, other potential treatments include pleuradesis and surgery. Because of their underlying pulmonary disease, many patients are challenging candidates for surgery, as their compromised tissue may not heal well.
The Zephyr® Endobronchial Valve is designed to block air from passing through the leaking channel in the lung and into the pleural cavity. Reducing or eliminating airflow through the leak may allow the tissue to heal and potentially allow the patient to return to normal breathing. After healing and depending on the patient’s condition, the physician can choose whether to leave the valves in place or remove them.
Treatment of persistent pulmonary air leaks using endobronchial valves has been discussed in numerous clinical papers. Travaline, et.al. (CHEST, April 2009), reports on the largest series of patients in which 40 patients were treated with Zephyr endobronchial valves in 17 international sites. In 92.5% of the treated patients, the air leaks either resolved or were significantly reduced. The author concludes, “Use of endobronchial valves is an effective, non-surgical, minimally-invasive intervention for patients with prolonged air leaks.”
| Air Leak Status following EBV Treatment | # patients | % patients | |||
| Complete resolution | 19 | 47.5% | |||
| Reduction in airleak | 18 | 45% | |||
| No change | 2 | 5% | |||
| Not reported | 1 | 2.5% |
The valves were left in place in 80% of the patients (32); eight patients elected to have valves removed after resolution of the airleak (20%). 85% of patients experienced no adverse events, and there were no deaths related to the valves or the EBV procedure.
Click here for a list of clinical references for Zephyr EBV treatment of prolonged air leak.
| A. | B. | C. |
| During normal breathing. inhaled air fills the lung and there is negative pressure in the pleural cavity. |
When a leak is present, air flows directly into the pleural cavity. |
The Zephyr® valve blocks air from passing through the leak, allowing the lung to re-expand normally. |
- Abolhoda, et.al. Prolonged air leak following radical upper lobectomy: an analysis of incidence and possible risk factors, CHEST 1998.
- Travaline, et.al. Treatment of Persistent Pulmonary Air Leaks Using Endobronchial Valves, CHEST; April 6, 2009.
- Cerfolio, RJ et.al. A prospective algorithm for the management of air leaks after pulmonary resection. Ann Thorac Surg 1998.
