Autologous Blood Patch (for persistent air leak)

Supplies needed:

  • Oval drape, extra blue towels
  • Arteriogram tray (if upsizing of chest tube is indicated)
  • Vinyl connecting tubing or three way adaptor
  • 60 cc syringe
  • New chest tube / dilator (if upsizing)
  • New Atrium (type based on which service patient is on)
  • Stay-fix
  • Large tegaderm
  • Split gauze
  • Wire: Operator's choice

Patient Prep:

  • Supine on VIR table, prep hemithorax around existing chest tube.


  • Consent: Exchange / Upsize Chest tube with Autologous Blood Patch, +/- Moderate sedation
  • Risks : Infection, worsening pneumothorax, technical failure including need for additional blood patch, +/- respiratory depression
  • Place large bore peripheral IV if patient does not have venous access
  • Upsize chest tube under fluoro guidance as needed (minimal size of chest tube 10Fr)
  • Proceduralist will withdraw 100 cc's of blood (with the 60 cc syringe) from patient and instill into pleural space via chest tube
  • Clamp chest tube for TWO hours but leave it attached to atrium
  • Patient to roll from side to side every 15 minutes for a two hour period
  • After two hours unclamp chest tube and place atrium back to LWS -20 mm Hg overnight