Risk factors for prolonged air leak after pulmonary resection.

Practical risk models stratifying the risk of prolonged air leak after pulmonary lobectomy have been developed and discussed. These scores may assist during preoperative patients' counseling, to identify patients at higher risk for prolonged air leak, who may benefit from the use of prophylactic measures such as the use of sealants, buttressed staple lines, or pleural tents. Furthermore, they may be used as standardized inclusion criteria for future randomized clinical trials testing the efficacy of these new technologies, and in doing so make the interpretation of results across different centers and studies more comparable. The clinical use of digital chest drainage units that permit quantitative measurement and recording of air leak flow and intrapleural pressure appears to add to the prediction and management of air leak after pulmonary resection. The use of risk scores based on these digital measures may set the stage for future investigations of active pleural management aimed at treating air leak by tailoring the level of intrapleural pressure to the needs of individual patients. Copyright 2010 Elsevier Inc. All rights reserved.