scholarly journals The Influence of Suction on Chest Drain Duration After Lobectomy Using Electronic Chest Drainage

2019 ◽  
Vol 107 (6) ◽  
pp. 1621-1625 ◽  
Author(s):  
Marike Lijkendijk ◽  
Peter B. Licht ◽  
Kirsten Neckelmann
Keyword(s):  
Chest Drain ◽  
Chest Drainage

scholarly journals Multicenter randomized study on comparison between electronic and traditional chest drainage systems

2019 ◽  
Author(s):  
Giuseppe Marulli ◽  
Giovanni Maria Comacchio ◽  
Mario Nosotti ◽  
Lorenzo Rosso ◽  
Paolo Mendogni ◽  
...  
Keyword(s):  
Interobserver Variability ◽  
Chest Drain ◽  
Chest Drainage ◽  
Drainage Systems ◽  
Traditional System ◽  
Air Leaks ◽  
Tube Removal ◽  
Space Effect ◽  
Digital Chest ◽  
Chest Tube Removal

Abstract Background In patients submitted to major pulmonary resection, post-operative length of stay is mainly influenced by duration of air leaks and chest tube removal. The measurement of air leaks largely relies on traditional chest drainage systems which are prone to subjective interpretation. Difficulty to differentiate between active air leaks and bubbles due to a pleural space effect may also lead to tentative drain clamping and prolonged time for chest drain removal. New digital systems allow continuous monitoring of air leaks, identifying subtle leakage that may be not visible during daily patient evaluation. Moreover, an objective assessment of air leaks may lead to a reduced interobserver variability and to an optimized timing of chest tube removal. Methods This study is a prospective randomized, interventional, multicenter trial designed to compare the electronic chest drainage system (Drentech™ Palm Evo) with the traditional system (Drentech™ Compact) in a cohort of patients undergoing pulmonary lobectomy through a standard 3-ports VATS approach for benign or malignant disease. It will enroll 382 patients in 3 Italian centers. Duration of chest drainage and length of hospital stay will be evaluated in the two groups. Moreover, it will be evaluated if the use of a digital chest system compared with a traditional system reduces the interobserver variability. Finally, it will be evaluated the possible advantages of the digital drain system to distinguish an active air leak from a pleural space effect, by the evaluation of intrapleural differential pressure, and to identify potential predictors of prolonged air leaks. Discussion To date few studies have been performed to evaluate clinical impact of digital drainage systems. The proposed prospective randomized trial will provide new knowledge to this research area by investigating and comparing the difference between digital and traditional chest drain systems. In particular, the objectives of this project are to evaluate the feasibility and usefulness of utilizing the digital chest drain and to provide new tools to identify patients at higher risk of developing prolonged air leaks. Trial registration number NCT03536130, Registered 24 May 2018 - Retrospectively registered, https://clinicaltrials.gov/ct2/results?cond=&term=NCT03536130&cntry=&state=&city=&dist=

scholarly journals Multicenter randomized study on the comparison between electronic and traditional chest drainage systems

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Giuseppe Marulli ◽  
Giovanni M. Comacchio ◽  
Mario Nosotti ◽  
Lorenzo Rosso ◽  
Paolo Mendogni ◽  
...  
Keyword(s):  
Interobserver Variability ◽  
Chest Drain ◽  
Chest Drainage ◽  
Drainage Systems ◽  
Traditional System ◽  
Air Leaks ◽  
Tube Removal ◽  
Space Effect ◽  
Digital Chest ◽  
Chest Tube Removal

Abstract Background In patients submitted to major pulmonary resection, the postoperative length of stay is mainly influenced by the duration of air leaks and chest tube removal. The measurement of air leaks largely relies on traditional chest drainage systems which are prone to subjective interpretation. Difficulty in differentiating between active air leaks and bubbles due to a pleural space effect may also lead to tentative drain clamping and prolonged time for chest drain removal. New digital systems allow continuous monitoring of air leaks, identifying subtle leakage that may be not visible during daily patient evaluation. Moreover, an objective assessment of air leaks may lead to a reduced interobserver variability and to an optimized timing for chest tube removal. Methods This study is a prospective randomized, interventional, multicenter trial designed to compare an electronic chest drainage system (Drentech™ Palm Evo) with a traditional system (Drentech™ Compact) in a cohort of patients undergoing pulmonary lobectomy through a standard three-port video-assisted thoracic surgery approach for both benign and malignant disease. The study will enroll 382 patients in three Italian centers. The duration of chest drainage and the length of hospital stay will be evaluated in the two groups. Moreover, the study will evaluate whether the use of a digital chest system compared with a traditional system reduces the interobserver variability. Finally, it will evaluate whether the digital drain system may help in distinguishing an active air leak from a pleural space effect, by the digital assessment of intrapleural differential pressure, and in identifying potential predictors of prolonged air leaks. Discussion To date, few studies have been performed to evaluate the clinical impact of digital drainage systems. The proposed prospective randomized trial will provide new knowledge to this research area by investigating and comparing the difference between digital and traditional chest drain systems. In particular, the objectives of this project are to evaluate the feasibility and usefulness of digital chest drainages and to provide new tools to identify patients at higher risk of developing prolonged air leaks. Trial registration ClinicalTrials.gov, NCT03536130. Retrospectively registered on 24 May 2018.

scholarly journals Neonatal Tension Pneumothorax.

2020 ◽  
pp. 1-2
Keyword(s):  
Bowel Perforation ◽  
Tension Pneumothorax ◽  
Male Infant ◽  
Clinical Image ◽  
Chest Drain ◽  
Chest Drainage ◽  
X Ray ◽  
Transient Improvement ◽  
Chest X Ray ◽  
Milk Feeding

Clinical Image A 690 g male infant delivered at 24+2 weeks had respiratory distress syndrome treated with Curosurf. Chest X-ray showed pulmonary interstitial emphysema (PIE) changes from day 5 onwards. On day 6 he suddenly developed desaturation with bradycardia, not responding to bagging. Auscultation revealed reduced air entry over right lung; endotracheal tube was changed for suspected blockage. Transient improvement noted. Then, the baby deteriorated again. Repeated auscultation showed markedly reduced air entry over right lung. Transillumination was positive. X-ray confirmed right tension pneumothorax but pneumoperitoneum was unexpected (Figure 1). The baby’s condition did not improve upon repeated chest tapping and required chest compression and Adrenaline. A chest drain was inserted and the baby then improved. Bowel perforation was once suspected but the infant improved so dramatically after chest drainage and milk feeding was subsequently established, ruling out bowel perforation.

scholarly journals A simple size-tailored algorithm for the removal of chest drain following minimally invasive lobectomy: a prospective randomized study

2021 ◽  
Author(s):  
Davor Stamenovic ◽  
Michael Dusmet ◽  
Thomas Schneider ◽  
Eric Roessner ◽  
Antje Messerschmidt
Keyword(s):  
Hospital Stay ◽  
Current Practice ◽  
Randomized Study ◽  
Length Of Hospital Stay ◽  
Pleural Space ◽  
Chest Drain ◽  
Chest Drainage ◽  
Vats Lobectomy ◽  
Drain Removal ◽  
Registration Number

Abstract Background The pleural space can resorb 0.11–0.36 ml/kg of body weight/hour (h) per hemithorax. There are only a limited number of studies on thresholds for chest drain removal (CDR) and all are based on arbitrary amounts, for example, 300 ml/day. We studied an individualized size-based threshold for CDR–specifically 5 ml/kg, a simple, easily applicable measure. Methods This is a single-center prospective randomized trial enrolling 80 patients undergoing VATS lobectomy. There were two groups: an experimental (E) group, in which once the daily output went down to 5 ml/kg the chest drain was removed and a control (C) group, with chest drain removal as per our current practice of less than 250 ml/day. Results The groups did not differ in pre- and peri- and postoperative characteristics, except for chest drain duration (mean, SD 2.02 ± 0.97 vs. 3.25 ± 1.39 days, p < 0.001) and length of hospital stay (median, IQR 4.5; 3 vs. 6; 2.75 days, p = 0.008) in favor of E group. The re-intervention rate was the same in both groups (once in each group). Conclusion The new threshold for chest drain removal following thoracoscopic lobectomy of 5 ml/kg/d leads to both shorter chest drainage and hospital stay without apparent increase in morbidity. (Clinical registration number: DRKS00014252).

The Innovated “Closed Chest Drainage System” of William Smoult Playfair (1871)

2019 ◽  
Vol 26 (6) ◽  
pp. 760-762
Author(s):  
Nikolaos Desimonas ◽  
Costas Tsiamis ◽  
Markos Sgantzos
Keyword(s):  
Drainage System ◽  
Chest Drain ◽  
Chest Drainage ◽  
Closed Chest ◽  
Liquid Seal ◽  
Major Turning Point ◽  
History Of ◽  
Water Seal ◽  
The 19Th Century ◽  
British Physician

During the 19th century, the addition of the water-seal system to a closed chest drain was a major turning point in the history of thoracic surgery. German physician Gotthard Bülau seems to have invented and used his own closed chest drainage device with a liquid-seal system in 1875, and published it in the year 1891. But, in 1871, British physician William Smoult Playfair seems to have thought of the subaqueous drainage and used such drainage to treat the thoracic empyema in children. The British physician stresses in his texts the effectiveness of his method of fully draining the thoracic empyemas while simultaneously preventing air from entering the pleural cavity. An appropriate honor must be attributed to Playfair, who used a subaqueous chest drainage system and appears to be the first to publish such a method.

New Chest Drainage Unit with Integrated CO2-Detector Demonstrates False Air Leak

2021 ◽  
pp. 155335062110474
Author(s):  
Jens Eckardt ◽  
Marike Lijkendijk ◽  
Peter B. Licht ◽  
Michael Stenger
Keyword(s):  
Porcine Model ◽  
Postoperative Management ◽  
Chest Drain ◽  
Thoracic Cavity ◽  
Air Leakage ◽  
Air Leak ◽  
Chest Drainage ◽  
Parenchymal Lesion ◽  
Direct Assessment ◽  
Color Indicator

Background Postoperative observed air leakage does not always originate from parenchymal defects but may arise from defects in the chest drainage unit, connections or reverse airflow in water seals. We investigated such false air leakage using a new chest drainage unit with a built-in CO2-detector and an electronic chest drainage unit. Methods Two types of chest drainage units were tested in a simple porcine model: A well-known electronic chest drainage unit and a new chest drainage unit with integrated CO2-detector. We created a setup of true air leakage—a parenchymal lesion, and false air leakage—allowing air to flow into the thoracic cavity alongside the chest drain. Results We demonstrated that the new chest drainage unit with a built-in CO2-detector can distinguish between experimentally induced true air leakage and false air leakage. Conclusion Available chest drainage systems do not allow direct assessment of true or false air leakage, which may increase chest drain duration unnecessarily. The integration of a CO2-sensitive color indicator into a chest drainage unit allows simple distinction between false air leak and true air leak, which may improve postoperative management.

scholarly journals Multicenter randomized study on comparison between electronic and traditional chest drainage systems

2019 ◽  
Author(s):  
Giuseppe Marulli ◽  
Giovanni Maria Comacchio ◽  
Mario Nosotti ◽  
Lorenzo Rosso ◽  
Paolo Mendogni ◽  
...  
Keyword(s):  
Chest Tube ◽  
Pleural Space ◽  
Chest Drain ◽  
Chest Drainage ◽  
Drainage Systems ◽  
Air Leaks ◽  
Tube Removal ◽  
Space Effect ◽  
Digital Chest ◽  
Chest Tube Removal

Abstract Background: In patients submitted to major pulmonary resection, post-operative length of stay is mainly influenced by duration of air leaks and chest tube removal. The measurement of air leaks largely relies on traditional chest drainage systems which are prone to subjective interpretation. Difficulty in differentiating between active air leaks and bubbles due to a pleural space effect may also lead to tentative drain clamping and prolonged time for chest drain removal. New digital systems allow continuous monitoring of air leaks, identifying subtle leakage that may be not visible during daily patient evaluation. Moreover, an objective assessment of air leaks may lead to a reduced interobserver variability and to an optimized timing of chest tube removal. Methods: This study is a prospective randomized, interventional, multicenter trial designed to compare the electronic chest drainage system (Drentech™ Palm Evo) with the traditional one (Drentech™ Compact) in a cohort of patients undergoing pulmonary lobectomy through a standard 3-ports VATS approach both for benign or malignant disease. It will enroll 382 patients in 3 Italian centers. Duration of chest drainage and length of hospital stay will be evaluated in the two groups. Moreover, it will be evaluated if the use of a digital chest system compared with a traditional system reduces theinterobserver variability. Finally, it will be evaluated if the digital drain system may help in distinguishing an active air leak from a pleural space effect, by the digital assessment of intrapleural differential pressure, and in identifying potential predictors of prolonged air leaks. Discussion : To date, few studies have been performed to evaluate clinical impact of digital drainage systems. The proposed prospective randomized trial will provide new knowledge to this research area by investigating and comparing the difference between digital and traditional chest drain systems. In particular, the objectives of this project are to evaluate the feasibility and usefulness of digital chest drainages and to provide new tools to identify patients at higher risk of developing prolonged air leaks.

Chest pain from chest drain

2011 ◽  
Vol 59 (S 01) ◽  
Author(s):  
D Schlarb ◽  
H Welp ◽  
V Kösek ◽  
J Sindermann ◽  
A Hoffmeier ◽  
...  
Keyword(s):  
Chest Pain ◽  
Chest Drain

scholarly journals Role of Thermal Ablation in Colorectal Cancer Lung Metastases

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 908
Author(s):  
Alexandre Delpla ◽  
Thierry de Baere ◽  
Eloi Varin ◽  
Frederic Deschamps ◽  
Charles Roux ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Thermal Ablation ◽  
Medical Oncology ◽  
Pulmonary Metastases ◽  
Lung Metastases ◽  
Stereotactic Ablative Radiotherapy ◽  
Chest Drainage ◽  
Results Of Surgery

Background: Consensus guidelines of the European Society for Medical Oncology (ESMO) (2016) provided recommendations for the management of lung metastases. Thermal ablation appears as a tool in the management of these secondary pulmonary lesions, in the same manner as surgical resection or stereotactic ablative radiotherapy (SABR). Methods: Indications, technical considerations, oncological outcomes such as survival (OS) or local control (LC), prognostic factors and complications of thermal ablation in colorectal cancer lung metastases were reviewed and put into perspective with results of surgery and SABR. Results: LC rates varied from 62 to 91%, with size of the metastasis (<2 cm), proximity to the bronchi or vessels, and size of ablation margins (>5 mm) as predictive factors of LC. Median OS varied between 33 and 68 months. Pulmonary free disease interval <12 months, positive carcinoembryonic antigen, absence of neoadjuvant chemotherapy and uncontrolled extra-pulmonary metastases were poor prognostic factors for OS. While chest drainage for less than 48 h was required in 13 to 47% of treatments, major complications were rare. Conclusions: Thermal ablation of a selected subpopulation of patients with colorectal cancer lung metastases is safe and can provide excellent LC and delay systemic chemotherapy.

scholarly journals Tractotomy using the Penrose drain guide for deep lung injury caused by chest drainage: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hironori Oyamatsu ◽  
Hideki Tsubouchi ◽  
Kunio Narita
Keyword(s):  
Lung Injury ◽  
Chest Tube ◽  
Drain Tube ◽  
Chest Drainage ◽  
Respiratory Condition ◽  
Penrose Drain ◽  
Multiple Rib Fractures ◽  
Lung Injuries ◽  
The Right ◽  
Damaged Vessel

Abstract Background Pulmonary tractotomy effectively treats deep pulmonary penetrating injuries; however, it requires the accurate insertion of forceps or a stapler into the wound tract. This report describes a case of tractotomy using the Penrose drain guide for a deep lung injury caused by chest drainage. Case presentation A 75-year-old man suffered multiple rib fractures and hemothorax. After admission, chest tube drainage was performed because the patient’s respiratory condition deteriorated due to increased right pleural effusion. However, as the chest tube was stabbing into the right upper lobe, a pulmonary tractotomy was performed to treat the injury. Cutting the visceral pleura just over the tip of the chest tube caused the tube to completely penetrate the lung. A Penrose drain tube was fixed to the chest tube, which was then removed. The Penrose drain tube completely penetrated the lung and was coupled to the anvil side of the stapler to guide it smoothly into the wound tract. After stapling left the wound tract open, selective suture ligation of the damaged vessel and bronchioles was performed. Conclusions Although the indications for tractotomy using the Penrose drain guide are limited, we believe that this technique can be useful in patients with deep stabbing or penetrating lung injuries with rod- or tube-shaped foreign body remnants.

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