Persistent Air Leaks in Spontaneous Pneumothorax: Risk Factors And The Role of Autologous Blood Pleurodesis

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Background: Persistent Air Leaks (PAL) complicate Spontaneous Pneumothorax (SP) prolonging hospitalization and morbidity. Autologous Blood Pleurodesis (ABP) is a minimally invasive option, but its efficacy versus chemical pleurodesis needs evaluation. The purpose of the study is to identify PAL risk factors in SP and compare ABP with tetracycline pleurodesis. Materials and methods: In this prospective study at NIDCH, Dhaka, 176 SP patients requiring chest tube drainage were enrolled and equally divided into PAL (Air leak >5 days) and non-PAL groups. Clinical, radiological and procedural factors were analyzed. PAL patients received ABP or tetracycline. Outcomes included leak resolution, cessation time, complications, hospital stay and recurrence. Analysis used SPSS v26, p 0.05 was significant. Results: PAL was associated with older age, low BMI, COPD, smoking, bullae and lung collapse >50%. Independent predictors were BMI <20 (OR=2.94) COPD (OR=2.72) bullae (OR=2.59) and collapse >50% (OR=2.87). ABP showed comparable resolution to tetracycline (95.45% vs. 88.64%, p=0.361) but faster cessation (2.4±1.3 vs. 3.6±1.7 days, p=0.003) and fewer complications (4.55% vs. 59.09%, p<0.001). Conclusion: PAL in SP is linked to clinical and radiological factors. ABP is safe, effective, and better tolerated, ensuring faster resolution and fewer complications. JCMCTA 2026 ; 37 (1) : 164-168

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