The Active Tube Clearance System a Novel Bedside Chest-Tube Clearance Device

2010 ◽  
Vol 5 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Shanaz Shalli ◽  
Edward M. Boyle ◽  
Diyar Saeed ◽  
Kiyotaka Fukamachi ◽  
William E. Cohn ◽  
...  
Keyword(s):  
Chest Tube ◽  
Large Diameter ◽  
Lung Surgery ◽  
Chest Tube Drainage ◽  
Chest Tubes ◽  
Tube Drainage ◽  
Novel Device ◽  
System A ◽  
Insertion Techniques ◽  
And Function

Objective Chest-tube clogging can lead to complications after heart and lung surgery. Surgeons often choose large-diameter chest tubes or place more than one chest tube when concerned about the potential for clogging. The purpose of this report is to describe the design and function of a proprietary active tube clearance system, a novel device that clears clots and debris from chest tubes. Device Description The active tube clearance system is a novel chest tube clearance apparatus developed to maintain chest tube patency. Chest tube clearance is achieved by advancing the specially designed clearance member back and forth within the chest tube under sterile conditions, breaking down and pulling clots back toward the drainage receptacle, thereby leaving the inner portion of the chest tube clear of any obstructing material. Conclusions By maintaining chest tube patency, chest tube drainage can be performed more safely, and this apparatus may possibly lead to the use of smaller chest tubes and less invasive insertion techniques.

scholarly journals Implication of pigtail catheter vs chest tube drainage

2018 ◽  
Vol 5 (9) ◽  
pp. 3686
Author(s):  
Alaa Elsayed ◽  
Rayan Alkhalifa ◽  
Muhannad Alodayni ◽  
Rakan Alanazi ◽  
Lara Alkhelaiwy ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Chest Tube ◽  
The Other ◽  
Chest Tube Drainage ◽  
Complication Rates ◽  
Pigtail Catheter ◽  
Chest Tubes ◽  
Tube Drainage ◽  
Other Hand ◽  
Lower Complication

Pigtail catheters and chest tubes have long been used for drainage of pleural collections for many years. In thoracic surgery, each technique is preferred in certain conditions. Pigtail catheters have the advantages of being smaller in size, more flexible, less traumatic, easier in insertion, and are associated with lower complication rates. They are particularly effective in draining non-viscid and non-coagulable fluids. The main disadvantages are their ineffectiveness in draining thick fluids, their higher liability to clogging, kinking, and obstruction. Chest tubes, on the other hand, have larger diameters allowing faster and more efficacious drainage of thick fluids and hemothorax. However, they are more painful, more distorting to tissues, and have higher complications rates. The aim of this article is to provide a review on both systems, and to compare the reported safety, efficacy, and complications of each.

Omitting Chest Tube Drainage after Subxiphoid Thoracoscopic Thymectomy

2019 ◽  
Vol 68 (05) ◽  
pp. 446-449 ◽  
Author(s):  
Hao Xu ◽  
Congying Guo ◽  
Yi Li ◽  
Lei Yang ◽  
Linyou Zhang
Keyword(s):  
Chest Tube ◽  
Operative Time ◽  
Pleural Cavity ◽  
Ultrasound Examination ◽  
Chest Tube Drainage ◽  
Chest Roentgenogram ◽  
Perioperative Outcomes ◽  
Chest Tubes ◽  
Chest Drainage ◽  
Tube Drainage

Background This study investigated the feasibility and safety of omitting chest tube drainage after subxiphoid thoracoscopic thymectomy. Methods From July 2018 through October 2018, 20 patients underwent subxiphoid thoracoscopic thymectomy without chest tube drainage. The clinical characteristics and perioperative outcomes of these patients are presented. Results All patients (10 males, 10 females; average age: 53.25 ± 12.50 years old) completed the operation. Chest tube drainage was omitted in a total of 20 patients. The operative time was 89.45 ± 49.80 minutes. No adverse events were observed. The bed-side ultrasound examination of the pleural cavity on the day of surgery showed a thimbleful of effusion and did not require thoracentesis. A postoperative chest roentgenogram on the next morning showed full expansion without pneumothorax in all patients. None of the patients required reintervention with chest drainage through the time of discharge. Conclusion The omission of chest tube drainage may be an alternative procedure for selected patients undergoing thoracoscopic thymectomy. The omission of chest tubes in thymectomy is safe, but further investigation is required.

scholarly journals Comparison of Single and Double Chest Tube Drainage Management in Patients Undergoing Thoracotomy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A A Elnori ◽  
H H Elsayed ◽  
A M Mostafa ◽  
M M M Kamal
Keyword(s):  
Chest Tube ◽  
Pleural Cavity ◽  
Chest Tube Drainage ◽  
Pleural Drainage ◽  
Inclusion Criteria ◽  
Chest Tubes ◽  
Single Tube ◽  
Tube Drainage ◽  
Specialized Hospital ◽  
Significant Difference

Abstract Background chest tube is the most commonly performed surgical procedure in thoracic surgery practice. It is defined as insertion of (chest tube) into the pleural cavity to drain air, blood, bile, pus, chyle or other fluids. Aim of the Work comparison of single and double chest tube drainage management in patients undergoing thoracotomy in the form of pain score, hospital stay, total drainage, residual collection after removal of chest tube and need for another chest tube at Cardiothoracic Academy Hospital and Ain Shams University Specialized Hospital (ASUSH). Patients and Methods this study was conducted on patients who undergone thoracotomy at the Cardiothoracic Academy Hospital and Ain Shams University Specialized Hospital throughout the last 6 months from March 2018 till August 2018. Data was collected retrospectively from 40 patients, 20 patients in each group. In the 20 patients in the ‘single-tube group', only one chest tube was inserted, and in the 20 patients in the ‘double-tube group', two chest tubes were inserted. Pre-, intra- and postoperative variables in both groups were compared. Results 40 patients met all inclusion criteria. The pre- and intraoperative characteristics of the patients were similar in both groups with no significant differences. The single-tube group was found to have a lesser amount of total pleural drainage than the double-tube group but there was no significant difference 202.50 cc vs 297.50 cc, respectively; (p > 0.05). Conclusion our results showed that the single chest tube drainage is more effective, reduces postoperative pain, hospitalization times and duration of drainage in patients who undergo thoracotomy.

Management of pneumothorax and bronchial fistulae

2016 ◽  
Author(s):  
Wissam Abouzgheib ◽  
Raquel Nahra
Keyword(s):  
Chest Tube ◽  
Chest Tube Drainage ◽  
Conservative Approach ◽  
Lung Collapse ◽  
Air Leak ◽  
Chest Tubes ◽  
Tube Drainage ◽  
Tube Removal ◽  
Associated Symptoms ◽  
Chest Tube Removal

The management of pneumothorax is dependent on size and associated symptoms. A conservative approach is preferred in small and asymptomatic ones. While a large pneumothorax warrants chest tube drainage, small bore could be as effective as large chest tubes and should be used first. The use of bedside ultrasound plays a major role in the acute management of pneumothorax and has an excellent negative predictive value. In some instances, there may be an associated air leak, caused by a broncho- or alveolopleural fistula, which can be managed by chest tube drainage, with or without suction, depending on the severity and extent of lung collapse. With a large air leak, wall suction is needed to keep the lung inflated. In small, intermittent air leaks, suction should be avoided to promote healing of the fistula. With the availability of one-way valves, management of these fistulae became easier, allowing blockage of the airway causing the air leak, and promoting healing and early chest tube removal.

THE COMBINATION OF INCREASED FIBRINOLYTIC ACTIVITY AND REDUCED PLATELET NUMBER AND FUNCTION CONTRIBUTES TO POSTOPERATIVE BLEEDING IN CARDIOPULMONARY BYPASS PATIENTS

1987 ◽  
Author(s):  
D S Holloway ◽  
L Summaria ◽  
J Sandesra ◽  
J P Vagher ◽  
J C Alexander ◽  
...  
Keyword(s):  
Platelet Count ◽  
Blood Loss ◽  
Chest Tube ◽  
Fibrinolytic Activity ◽  
Chest Tube Drainage ◽  
Postoperative Blood Loss ◽  
Platelet Aggregability ◽  
Tube Drainage ◽  
Platelet Number ◽  
And Function

Both increased fibrinolysis and reduced platelet number and function have been reported postoperatively in cardiopulmonary (CP) bypass patients, but correlations with postoperative bleeding often have not been found. We simultaneously evaluated platelet and fibrinolytic parameters to assess their individual and combined contributions to postoperative blood loss. Plasminogen (pig) concentration, alpha-2-antiplasmin (AP) concentration, free protease activity (fPA), platelet count, and platelet aggregability were measured in nine patients undergoing cardiopulmonary bypass surgery. Hematocrit was also measured in order to determine the degree of blood dilution during CP bypass. Chest tube drainage was used as the measure of postoperative blood loss. Pig and AP concentrations decreased With hemodilution during bypass. fPA did not decrease with dilution but remained at pre-bypass levels. Platelet count decreased during bypass but aggregability to ADP and arachidonic acid (AA) did not change significantly. Following protamine administration there was a large increase (83$) in fPA, the platelet count showed a further drop (from 61% to 50% of pre-bypass levels), and platelet aggregability decreased significantly (from 95% to 34% of pre-bypass levels). Early chest tube drainage (1st 4 hrs postoperatively) correlated positively (p[0.05) with the combination of increase in free protease activity and decrease in platelet count. Total chest tube drainage correlated positively (p[ 0.05) with the combination of increase in free protease activity and decrease in platelet aggregability to ADP. None of the measured parameters individually showed significant correlation with chest tube drainage. In this patient sampling, however, the combination of changes in fibrinolytic activity and changes in platelet function did correlate significantly with chest tube drainage. These data indicate that the increased fibrinolytic activity and the decreased platelet number and function have a synergistic effect on postoperative blood loss in CP bypass patients.

Clinico-bacteriological Profile and Outcome of Empyema Thoracis in Children at a Tertiary Care Hospital of Central Nepal

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Atanu Pan ◽  
Debarshi Jana
Keyword(s):  
Ct Scan ◽  
Broad Spectrum ◽  
Chest Tube ◽  
Chest Tube Drainage ◽  
Diagnostic Tools ◽  
High Morbidity ◽  
Care Hospital ◽  
Empyema Thoracis ◽  
First Line ◽  
Tube Drainage

Background: Empyema thoracis (ET) is a serious infection of the pleural space. Despite the availability of broad spectrum antibacterial, improved vaccination coverage and better diagnostic tools, Empyema Thoracis remains associated with high morbidity worldwide. Delay   in   early   diagnosis,   failure   to institute   appropriate   antimicrobial   therapy,   multidrug resistant   organisms,   malnutrition,   comorbidities,   poor health  seeking  behaviour  and  high treatment  cost  burden contribute  to  increased  morbidity  in  children. The available  treatment  options  include  intravenous broad-spectrum antibiotics  either  alone  or  in  combination  with surgical  procedure  (thoracocentesis,  chest  tube  drainage, fibrinolytic  therapy,  decortications  with  video  assistedthoracoscopic surgery (VATS) and open drainage. Methods: Fifty Children between 1 month to 16 years admitted in the Pediatrics Ward, PICU of College of Medical Sciences, Bharatpur,Nepal. Data analysis was done by SPSS 24.0. Results: Present study found that according to blood culture, 3(6.0%) patients had enterococcus, 40(80.0%) patients had no growth, 2(4.0%) patients had pseudomonas, 4(8.0%) patients had staphylococcus and 1(2.0%) patients had streptococcus. We found that 20(40.0%) patients had done CT scan thorax, 30(60.0%) patients had not done CT scan thorax and 32(64.0%) patients had Amoxiclav first line antibiotic and 18(36.0%) patients had Ceftriaxone first line antibiotic. Conclusions: Suitable antibiotics and prompt chest tube drainage is an effective method of treatment of childhood empyema, especially in resource-poor settings. Majority of the patients progress on this conservative management and have good recovery on follow up.  

Chest Tube Drainage of Transudative Pleural Effusions Hastens Liberation From Mechanical Ventilation

CHEST Journal ◽  
2011 ◽  
Vol 139 (3) ◽  
pp. 519-523 ◽  
Author(s):  
Yizhak Kupfer ◽  
Chanaka Seneviratne ◽  
Kabu Chawla ◽  
Kavan Ramachandran ◽  
Sidney Tessler
Keyword(s):  
Mechanical Ventilation ◽  
Chest Tube ◽  
Chest Tube Drainage ◽  
Pleural Effusions ◽  
Tube Drainage

Empyema in Children: Clinical Course and Long-Term Follow-up

PEDIATRICS ◽  
1984 ◽  
Vol 73 (5) ◽  
pp. 587-593 ◽  
Author(s):  
F. John McLaughlin ◽  
D. A. Goldmann ◽  
D. M. Rosenbaum ◽  
G. B. C. Harris ◽  
S. R. Schuster ◽  
...  
Keyword(s):  
Flow Rate ◽  
Chest Tube ◽  
Clinical Course ◽  
Chest Tube Drainage ◽  
Haemophilus Influenzae Type ◽  
Healthy Children ◽  
Long Term Outcome ◽  
Tube Drainage ◽  
Pleural Thickening

Sixteen patients, aged 1 month to 15 years, were studied to determine the clinical course and longterm outcome of empyema in previously healthy children. The pathogens responsible were Haemophilus influenzae type b (seven patients), Staphylococcus aureus (five patients), Streptococcus pneumoniae (three patients), and viridans group Streptococcus (one patient). All patients had loculated fluid showing on chest roentgenographs. Chest tube drainage yielded 20 to 1,495 mL (mean 293 mL) during the first three days, accounting for 83% of total drainage. Chest tubes were removed after three to 17 days (mean ten days). Only slight roentgenographic improvement showed during chest tube drainage. Three patients required an open thoracotomy because of an unsatisfactory clinical response. Hospitalization ranged from eight to 77 days (mean 25 days). All patients had residual pleural thickening shown on chest roentgenographs taken at discharge. Thirteen patients were seen 5 to 140 months (mean 66 months) after discharge. Findings from physical examination were normal in 12 of the 13 patients. Pulmonary function tests in ten of the 13 patients revealed (mean percent predicted ± 1 SD): vital capacity 92 ± 12, residual volume 85 ± 31, total lung capacity 92 ± 13, peak flow rate 96 ± 17, forced expiratory volume in 1 second 90 ± 13, and maximal mid-expiratory flow rate 93 ± 25. In all but one patient, findings on chest roentgenograms were normal or showed slight pleural thickening. Children with loculated empyema can be treated successfully with antibiotics and chest tube drainage. Few patients require open drainage, and further surgery is rarely required. The long-term outcome is excellent.

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