A common complication following lung resection surgery is the presence of a post-operative air leak. This occurs when the resected lung tissue does not seal adequately, resulting in continued leakage of air from the lung. For most patient, an air leak will self-resolve by maintaining a drainage catheter in the chest for a prolonged period. However, for some patients, additional measures are required to help seal the affected tissue. Known strategies for managing post-operative air leak include placing one-way valves, surgical revision, and chemical pleurodesis. Chemical pleurodesis involves injecting an irritant through the chest drainage catheter to promote sealing of the leaking lung tissue. While many agents exist for chemical pleurodesis, a relatively new method for treating an air leak is by using dextrose solution. Dextrose is appealing due to low cost and availability. Dextrose solution has shown some efficacy in other countries and undergone Phase 1 clinical investigation in Canada to show its safety and dosing recommendations. In this study, our aim is to compare the effectiveness of using dextrose solution for treating post-operative air leak compared to usual care with chest tube drainage alone.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
80
A one time intrapleural instillation of 150mL of dextrose will be administered following analgesia with 10mL lidocaine
maintenance of post operative pulmonary drain without additional intervention
Time to air leak resolution
air leak \<20mL/min as measured by digital tracking atrium
Time frame: from randomization to resolution of air leak (<20 mL/min), assessed up to 30 days
Chest tube duration
time until chest tube removal
Time frame: from randomization until chest tube removal, assessed up to 30 days
Hospital Length of Stay
time until patient discharge
Time frame: from randomization until hospital discharge, assessed up to 30 days
Adverse Events
occurrence of complications including respiratory failure, pneumonia, and fever
Time frame: from randomization through 30 days post-procedure
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