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Fibrin glue for persistent pneumothorax in neonates

Shikha Sarkar1, Naveed Hussain, Victor Herson

  • 1Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Connecticut School of Medicine, Farmington, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|January 31, 2003
PubMed

Insights

Fibrin glue effectively treated persistent pneumothoraces in newborns, resolving air leaks within 24 hours for most infants. However, this treatment carries significant risks, including bradycardia and hypercalcemia.

Area of Science:

  • Neonatal Medicine
  • Pediatric Surgery
  • Thoracic Surgery

Background:

  • Persistent air leak in newborns, often due to pneumothorax, presents a significant clinical challenge.
  • Traditional treatments may be invasive or prolonged, necessitating alternative therapeutic approaches.

Purpose of the Study:

  • To evaluate the efficacy and safety of fibrin glue for treating persistent pneumothorax in neonates.
  • To assess the resolution rate of air leak and identify potential complications associated with fibrin glue instillation.

Main Methods:

  • Fibrin glue was administered to eight newborns with significant pneumothoraces averaging 10 days duration.
  • Treatment outcomes, including air leak resolution and recurrence, were monitored.
  • Adverse events such as bradycardia, hypercalcemia, diaphragmatic paralysis, contralateral pneumothorax, and tissue necrosis were recorded.

Main Results:

  • Six of eight infants experienced reduced or resolved air leak within 24 hours of fibrin glue therapy.
  • Two infants required a second course of treatment for recurrent pneumothorax.
  • Complications included bradycardia (N=2), hypercalcemia (N=2), diaphragmatic paralysis (N=2), contralateral pneumothorax (N=1), and localized tissue necrosis (N=1).

Conclusions:

  • Fibrin glue demonstrates effectiveness in managing intractable neonatal pneumothorax.
  • The use of fibrin glue is associated with a notable spectrum of potential complications that require careful consideration and monitoring.

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