Novel bronchoscopic management of airway bleeding with absorbable gelatin and thrombin slurry Journal Article
| Authors: | Peralta, A. R.; Chawla, M.; Lee, R. P. |
| Article Title: | Novel bronchoscopic management of airway bleeding with absorbable gelatin and thrombin slurry |
| Abstract: | Background: Airway bleeding, either spontaneous or as a result of bronchoscopy, is associated with significant morbidity and mortality. Multiple bronchoscopic techniques are available to achieve complete hemostasis or as a bridge to definitive therapies. Methods: We report our experience on the feasibility of endobronchial instillation of an absorbable gelatin and thrombin slurry (GTS) for the treatment of spontaneous hemoptysis and procedure-related bleeding. Results: We identified 13 cases in which GTS was used for endobronchial hemostasis when standard bronchoscopic measures like cold saline, epinephrine, and in some cases balloon occlusion were not successful. GTS was delivered through the working channel of the bronchoscope in 10 cases and through the distal port of a bronchial blocker in the remaining 3 cases. Median age was 69 years (range, 52 to 79 y). Eight cases corresponded to spontaneous hemoptysis and 5 cases to diagnostic or therapeutic procedures. Bleeding was considered severe in 9 (70%) cases. All but 1 case were associated with malignancy. Hemostasis was achieved in 10 (77%) cases by using standard measures in addition to GTS. No patient adverse events at 30 days or damage to the equipment were identified. Conclusions: Bronchoscopic instillation of an absorbable GTS is feasible and may be used in cases of spontaneous or procedure-related bleeding in addition to conventional measures. It can be delivered through the working channel of the bronchoscope or through the distal port available in some bronchial blockers. Controlled studies are necessary to determine the safety and efficacy of this novel technique. © 2018 Wolters Kluwer Health, Inc. All rights reserved. |
| Keywords: | adult; clinical article; controlled study; aged; middle aged; bleeding; lung cancer; prothrombin time; feasibility study; bronchoscopy; platelet count; partial thromboplastin time; thrombin; gelfoam; airway obstruction; hemoptysis; hemostasis; transbronchial biopsy; gelatin; human; male; female; priority journal; article; absorbable gelatin; endobronchial hemostasis; procedure related bleeding; spontaneous hemoptysis |
| Journal Title: | Journal of Bronchology and Interventional Pulmonology |
| Volume: | 25 |
| Issue: | 3 |
| ISSN: | 1944-6586 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2018-07-01 |
| Start Page: | 204 |
| End Page: | 211 |
| Language: | English |
| DOI: | 10.1097/lbr.0000000000000470 |
| PROVIDER: | scopus |
| PMCID: | PMC6019569 |
| PUBMED: | 29351111 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 August 2018 -- Source: Scopus |
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