From Alveolar Injury to Precision Perioperative Care: Integrating Molecular Biomarkers and Technology-Enabled Strategies for Prolonged Air Leak After Lung Resection
This narrative review reframes prolonged air leak (PAL) after lung resection as more than a technical failure of alveolar-pleural sealing, highlighting the role of inflammation, epithelial injury, oxidative stress, and impaired tissue repair in delayed air leak resolution. The authors review emerging biomarkers associated with PAL risk and persistence, and discuss how quantitative digital chest drainage data may complement these biological markers by providing objective assessment of air leak dynamics. The paper proposes a future framework combining biomarker profiles and digital drainage parameters to support risk stratification, PAL phenotyping, and more individualized prevention and management strategies, although further prospective validation is required before clinical implementation.
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