The use of a digital drainage system to measure the predictive factors of prolonged air leak

Objectives - to analyze the causes of postoperative air leak and to propose a therapeutic and diagnostic algorithm for this complication. Material and methods. The study includes the analysis of the prolonged air leak causes after various lung resections, the classification of the causes according to their affiliation, the designed definitions of basic concepts. Results. The most common causes of prolonged air leakage are the incompetence of the lung resection line, the undetected (unresolved) cause of pneumothorax, the inadequate drainage system function. Various tactical approaches to this problem were described. Depending on the effectiveness of the auxiliary techniques, the indications for repeated operations were determined. Conclusion. Knowledge of the causes of postoperative prolonged pathological air leak is the basis for the optimal management of patients after lung resection.

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Prediction of prolonged air leak after lung resection using continuous log data of flow by digital drainage system

General Thoracic and Cardiovascular Surgery ◽

10.1007/s11748-019-01073-y ◽

2019 ◽

Vol 67 (8) ◽

pp. 684-689 ◽

Cited By ~ 1

Author(s):

Masaki Goto ◽

Keiju Aokage ◽

Keigo Sekihara ◽

Tomohiro Miyoshi ◽

Kenta Tane ◽

...

Keyword(s):

Lung Resection ◽

Drainage System ◽

Air Leak ◽

Log Data ◽

Prolonged Air Leak

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Complications after Chest Tube Removal and Reinterventions in Patients with Digital Drainage Systems

Journal of Clinical Medicine ◽

10.3390/jcm8122092 ◽

2019 ◽

Vol 8 (12) ◽

pp. 2092

Author(s):

Yi-Ying Lee ◽

Po-Kuei Hsu ◽

Chien-Sheng Huang ◽

Yu-Chung Wu ◽

Han-Shui Hsu

Keyword(s):

Predictive Factors ◽

Lung Resection ◽

Drainage System ◽

Drainage Tube ◽

Air Leak ◽

Chest Drainage ◽

Drainage Systems ◽

Air Leaks ◽

Thoracic Drainage ◽

Tube Removal

Introduction: Digital thoracic drainage systems are a new technology in minimally invasive thoracic surgery. However, the criteria for chest tube removal in digital thoracic drainage systems have never been evaluated. We aim to investigate the incidence and predictive factors of complications and reinterventions after drainage tube removal in patients with a digital drainage system. Method: Patients who received lung resection surgery and had their chest drainage tubes connected with a digital drainage system were retrospectively reviewed. Results: A total of 497 patients were monitored with digital drainage systems after lung resection surgery. A total of 175 (35.2%) patients had air leak-related complications after drainage tube removals, whereas 25 patients (5.0%) required reintervention. We identified that chest drainage duration of five days was an optimal cut-off value in predicting air leak-related complications and reinterventions. In multiple logistic regression analysis, previous chest surgery history; small size (16 Fr.) drainage tubes; the presence of initial air leaks, defined as air leaks recorded by the digital drainage system immediately after operation; and duration of chest drainage ≥5 days were independent factors of air leak-related complications, whereas the presence of initial air leaks and duration of chest drainage ≥5 days were independent predictive factors of reintervention after drainage tube removal. Conclusion: Air leak-related complications and reinterventions after drainage tube removals happened in 35.2% and 5.0% of patients with digital thoracic drainage systems. The management of chest drainage tubes in patients with predictive factors, i.e., the presence of initial air leaks and duration of chest drainage of more than five days, should be treated with caution.

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Predictive factors and economic impact of prolonged air leak after pulmonary resection

General Thoracic and Cardiovascular Surgery ◽

10.1007/s11748-021-01677-3 ◽

2021 ◽

Author(s):

Masaya Yotsukura ◽

Yu Okubo ◽

Yukihiro Yoshida ◽

Kazuo Nakagawa ◽

Shun-ichi Watanabe

Keyword(s):

Economic Impact ◽

Predictive Factors ◽

Pulmonary Resection ◽

Air Leak ◽

Prolonged Air Leak

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A Prolonged Air Leak Score for Lung Cancer Resection: An Analysis of The Society of Thoracic Surgeons General Thoracic Surgery Database

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2019.05.069 ◽

2019 ◽

Vol 108 (5) ◽

pp. 1478-1483 ◽

Cited By ~ 7

Author(s):

Christopher W. Seder ◽

Sanjib Basu ◽

Timothy Ramsay ◽

Gaetano Rocco ◽

Shanda Blackmon ◽

...

Keyword(s):

Lung Cancer ◽

Thoracic Surgery ◽

Air Leak ◽

Cancer Resection ◽

Prolonged Air Leak ◽

General Thoracic Surgery

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Intraoperative ventilatory leak predicts prolonged air leak after lung resection: A retrospective observational study

PLoS ONE ◽

10.1371/journal.pone.0187598 ◽

2017 ◽

Vol 12 (11) ◽

pp. e0187598 ◽

Cited By ~ 2

Author(s):

Won Ho Kim ◽

Hyung-Chul Lee ◽

Ho-Geol Ryu ◽

Hyun-Kyu Yoon ◽

Chul-Woo Jung

Keyword(s):

Observational Study ◽

Lung Resection ◽

Retrospective Observational Study ◽

Air Leak ◽

Prolonged Air Leak

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Intrabronchial Valve Treatment for Prolonged Air Leak: Can We Justify the Cost?

Canadian Respiratory Journal ◽

10.1155/2016/2867547 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Eitan Podgaetz ◽

Felix Zamora ◽

Heidi Gibson ◽

Rafael S. Andrade ◽

Eric Hall ◽

...

Keyword(s):

Individual Patient Data ◽

Cost Effective ◽

Air Leak ◽

Levels Of Care ◽

Air Leaks ◽

Limited Experience ◽

Tube Removal ◽

Prolonged Air Leak ◽

Chest Tube Removal ◽

The Cost

Background.Prolonged air leak is defined as an ongoing air leak for more than 5 days. Intrabronchial valve (IBV) treatment is approved for the treatment of air leaks.Objective.To analyze our experience with IBV and valuate its cost-effectiveness.Methods.Retrospective analysis of IBV from June 2013 to October 2014. We analyzed direct costs based on hospital and operating room charges. We used average costs in US dollars for the analysis not individual patient data.Results.We treated 13 patients (9 M/4 F), median age of 60 years (38 to 90). Median time from diagnosis to IBV placement was 9.8 days, time from IBV placement to chest tube removal was 3 days, and time from IBV placement to hospital discharge was 4 days. Average room and board costs were $14,605 including all levels of care. IBV cost is $2750 per valve. The average number of valves used was 4. Total cost of procedure, valves, and hospital stay until discharge was $13,900.Conclusion.In our limited experience, the use of IBV to treat prolonged air leaks is safe and appears cost-effective. In pure financial terms, the cost seems justified for any air leak predicted to last greater than 8 days.

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Autologous Blood Pleurodesis: What Is the Optimal Time Interval and Amount of Blood?

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0041-1727129 ◽

2021 ◽

Author(s):

Alessio Campisi ◽

Andrea Dell'Amore ◽

Yonghui Zhang ◽

Zhitao Gu ◽

Angelo Paolo Ciarrocchi ◽

...

Keyword(s):

Chest Tube ◽

Autologous Blood ◽

Optimal Time ◽

Time Interval ◽

Air Leak ◽

Increased Risk ◽

Tube Removal ◽

Blood Patch ◽

Prolonged Air Leak ◽

Chest Tube Removal

Abstract Background Air leak is the most common complication after lung resection and leads to increased length of hospital (LOH) stay or patient discharge with a chest tube. Management by autologous blood patch pleurodesis (ABPP) is controversial because few studies exist, and the technique has yet to be standardized. Methods We retrospectively reviewed patients undergoing ABPP for prolonged air leak (PAL) following lobectomy in three centers, between January 2014 and December 2019. They were divided into two groups: Group A, 120 mL of blood infused; Group B, 60 mL. Propensity score-matched (PSM) analysis was performed, and 23 patients were included in each group. Numbers and success rates of blood patch, time to cessation of air leak, time to chest tube removal, reoperation, LOH, and complications were examined. Univariate and multivariate analysis of variables associated with an increased risk of air leak was performed. Results After the PSM, 120 mL of blood is statistically significant in reducing the number of days before chest tube removal after ABPP (2.78 vs. 4.35), LOH after ABPP (3.78 vs. 10.00), and LOH (8.78 vs. 15.17). Complications (0 vs. 4) and hours until air leak cessation (6.83 vs. 3.91, range 1–13) after ABPP were also statistically different (p < 0.05). Air leaks that persisted for up to 13 hours required another ABPP. No patient had re-operation or long-term complications related to pleurodesis. Conclusion In our experience, 120 mL is the optimal amount of blood and the procedure can be repeated every 24 hours with the chest tube clamped.

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