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Bronchopleural Fistula


>A bronchopleural fistula (BPF) is a persistent pathological ­communication between the central airways and the pleural cavity (excluding small peripheral air leaks for the purposes of this discussion). The incidence varies from 4.5 to 20% following pneumonectomy or 0.5% following lobectomy with a high mortality of between 18 and 50% (1).


  • Bronchopleural fistula
  • Subcutaneous emphysema
  • Chest drain
  • Stump dehiscence
  • Flexible bronchoscopy
  • Lung isolation
  • Ventilation
  • Clagett procedure
  • Open drainage procedures
  • High-frequency jet ventilation

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Figure 31-1
Figure 31.2

Selected References

  1. Cerfolio RJ. The incidence, etiology, and prevention of postresectional bronchopleural fistula. Semin Thorac Cardiovasc Surg. 2001;13:3–7.

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  2. Haraguchi S, Koizumi K, Hioki M, et al. Analysis of risk factors for postpneumonectomy bronchopleural fistulas in patients with lung cancer. J Nippon Med Sch. 2006;73:314–9.

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  3. Clagett O, Geraci J. A procedure for the management of postpneumonectomy empyema. J Thorac Cardiovasc Surg. 1963;45:141–5.

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  4. Benjaminsson E, Klain M. Intraoperative dual-mode independent lung ventilation of a patient with bronchopleural fistula. Anesth Analg. 1981;60:118–9.

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  5. Carvalho P, Thompson WH, Riggs R, et al. Management of bronchopleural ­fistula with a variable-resistance valve and a single ventilator. Chest. 1997;111:1452–4.

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  6. Ihra G, Gockner G, Kashanipour A, et al. High-frequency jet ventilation in European and North American institutions, developments and clinical practice. Eur J Anaesthesiol. 2000;17:418–30.

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  7. Bishop MJ, Benson MD, Sato P, et al. Comparison of high-frequency jet ventilation with conventional mechanical ventilation from bronchopleural fistula. Anesth Analg. 1987;66:833–88.

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  8. Baumann MH, Sahn SA. Medical management and therapy of bronchopleural fistulas in the mechanically ventilated patient. Chest. 1990;97:721–8.

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Ng, JM. (2012). Bronchopleural Fistula. In: Hartigan, P. (eds) Practical Handbook of Thoracic Anesthesia. Springer, Boston, MA.

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