Air leak and pleural space management

Parenchymal air leakage following lung resection is, unfortunately, the rule and not the exception. Although air leakage does negatively impact the patient's hospital course, it is self-limiting in most cases. If there is no sign of improvement in the air leak by 1 week, bronchoscopy is recommended. There is no definitive timing of reintervention, but if the lung is expanded, expectant management is still the most prudent course of action. For larger air leaks, especially in the presence of an incompletely expanded lung or residual ipsilateral pleural space, reintervention should be considered if there is no improvement by 1 to 2 weeks.