scholarly journals Impact of the learning curve in the use of a novel electronic chest drainage system after pulmonary lobectomy: a case-matched analysis on the duration of chest tube usage

2011 ◽  
Vol 13 (5) ◽  
pp. 490-493 ◽  
Author(s):  
C. Pompili ◽  
A. Brunelli ◽  
M. Salati ◽  
M. Refai ◽  
A. Sabbatini
Keyword(s):  
Learning Curve ◽  
Chest Tube ◽  
Drainage System ◽  
Pulmonary Lobectomy ◽  
Chest Drainage

Positioning of chest tubes: effects on pressure and drainage

1997 ◽  
Vol 6 (1) ◽  
pp. 33-38 ◽  
Author(s):  
PA Gordon ◽  
JM Norton ◽  
JM Guerra ◽  
ST Perdue
Keyword(s):  
Beneficial Effect ◽  
Chest Tube ◽  
Drainage System ◽  
Drainage Tube ◽  
Chest Tubes ◽  
Glass Bottle ◽  
Chest Drainage ◽  
Tube Drainage ◽  
Chest Drainage Tube ◽  
Patient’S Outcome

BACKGROUND: Maintaining a chest drainage tube in a position that is free of dependent loops, as is commonly recommended, can be very difficult. Is there a beneficial effect on the patient's outcome when the drainage tubing is free of dependent loops? OBJECTIVE: The purpose of this study was to determine, under controlled laboratory conditions, (1) what are the differences in drainage with tubing in straight, coiled, or dependent-loop (with and without periodic lifting) positions and (2) what are the differences in pressure with each of the four tubing conditions? METHODS: In laboratory simulations, pressure and drainage were observed in a chest tube drainage system that was connected to a glass bottle simulating the lung. Pressure and drainage were measured for 1 hour with the drainage tubing placed in straight, coiled, and dependent-loop positions. For the periodic lifting condition, the dependent loop was lifted and drained every 15 minutes. RESULTS: We found no differences in pressure or drainage between straight and coiled positions of the drainage tubing. However, with the dependent-loop position, pressure at the "lung" side increased from about -18 cm H2O to as high as +8 cm H2O. Drainage dropped to zero without tube lifting. When the tube was lifted and drained every 15 minutes, there was no difference in drainage with the tubing in the straight or coiled positions. CONCLUSION: Findings support recommendations to maintain tubing free of dependent loops by placing tubing in straight or coiled positions. Frequently lifting and draining a dependent loop will provide the same total drainage amount as maintaining the tubing in a straight or coiled position, but pressures may be altered sufficiently within the tube to exceed recommended levels.

scholarly journals Digital versus analogue chest drainage system in patients with primary spontaneous pneumothorax: a randomized controlled trial

2020 ◽  
Author(s):  
Kris Mooren ◽  
Dieuwertje Ruigrok ◽  
Peter W.A. Kunst ◽  
Marielle M.J. Blacha ◽  
Ben Tomlow ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hospital Stay ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Controlled Trial ◽  
Drainage System ◽  
Air Leakage ◽  
Chest Drainage ◽  
Tube Drainage ◽  
Randomized Controlled

Abstract Background: Patients with a primary spontaneous pneumothorax (PSP) who are treated with chest tube drainage are traditionally connected to an analogue chest drainage system, containing a water seal and using a visual method of monitoring air leakage. Electronic systems with continuous digital monitoring of air leakage provide better insight into actual air leakage and changes in leakage over time, which may lead to a shorter length of hospital stay.Methods: We performed a randomized controlled trial comparing the digital with analogue system, with the aim of demonstrating that use of a digital drainage system in PSP leads to a shorter hospital stay.Results: In 102 patients enrolled with PSP we found no differences in total duration of chest tube drainage and hospital stay between the groups. However, in a post-hoc analysis, excluding 19 patients needing surgery due to prolonged air leakage, hospital stay was significantly shorter in the digital group (median 1 days, IQR 1-5 days) compared to the analogue group (median 3 days, IQR 2-5 days) (p 0.014). Treatment failure occurred in 3 patients in both groups; the rate of recurrence within 12 weeks was not significantly different between groups (16% in the digital group versus 8% in the analogue group, p 0.339).Conclusion: Length of hospital stay was not shorter in patients with PSP when applying a digital drainage system compared to an analogue drainage system. However, in the large subgroup of uncomplicated PSP, a significant reduction in duration of drainage and hospital stay was demonstrated with digital drainage. These findings suggest that digital drainage may be a practical alternative to manual aspiration in the management of PSP. Trial registration: https://www.trialregister.nl/trial/4022. Registered 22 September 2013 - Retrospectively registered, Trial NL4022 (NTR4195)

scholarly journals Digital versus analogue chest drainage system in patients with primary spontaneous pneumothorax: a randomized controlled trial

2020 ◽  
Author(s):  
Kris Mooren ◽  
Dieuwertje Ruigrok ◽  
Peter W.A. Kunst ◽  
Marielle M.J. Blacha ◽  
Ben Tomlow ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hospital Stay ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Controlled Trial ◽  
Drainage System ◽  
Length Of Hospital Stay ◽  
Air Leakage ◽  
Chest Drainage ◽  
Randomized Controlled

Abstract Background Patients with a primary spontaneous pneumothorax (PSP) who are treated with chest tube drainage are traditionally connected to an analogue chest drainage system, containing a water seal and using a visual method of monitoring air leakage. Electronic systems with continuous digital monitoring of air leakage provide better insight into actual air leakage and changes in leakage over time, which may lead to a shorter length of hospital stay. Aim and methods We performed a randomized controlled trial comparing the digital with analogue system, with the aim of demonstrating that use of a digital drainage system in PSP leads to a shorter hospital stay. Results In 102 patients enrolled with PSP we found no differences in total duration of chest tube drainage and hospital stay between the groups. However, in a post-hoc analysis, excluding 19 patients needing surgery due to prolonged air leakage, hospital stay was significantly shorter in the digital group (median 1 days, IQR 1-5 days) compared to the analogue group (median 3 days, IQR 2-5 days) (p 0.014). Treatment failure occurred in 3 patients in both groups; the rate of recurrence within 12 weeks was not significantly different between groups (16% in the digital group versus 8% in the analogue group, p 0.339). Conclusion Length of hospital stay was not shorter in patients with PSP when applying a digital drainage system compared to an analogue drainage system. However, in the large subgroup of uncomplicated PSP, a significant reduction in duration of drainage and hospital stay was demonstrated with digital drainage. These findings suggests that digital drainage may be a practical alternative to manual aspiration in the management of PSP. Trial registration: https://www.trialregister.nl/trial/4022. Registered 22 September 2013 - Retrospectively registered, Trial NL4022 (NTR4195)

scholarly journals Digital versus analogue chest drainage system in patients with primary spontaneous pneumothorax: a randomized controlled trial

2020 ◽  
Author(s):  
Kris Mooren ◽  
Dieuwertje Ruigrok ◽  
Peter W.A. Kunst ◽  
Marielle M.J. Blacha ◽  
Ben Tomlow ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hospital Stay ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Controlled Trial ◽  
Drainage System ◽  
Length Of Hospital Stay ◽  
Air Leakage ◽  
Chest Drainage ◽  
Randomized Controlled

Abstract Background Patients with a primary spontaneous pneumothorax (PSP) who are treated with chest tube drainageare traditionally connected to an analogue chest drainage system, containing a water seal and using a visual method of monitoring air leakage. Electronic systems with continuous digital monitoring of air leakage provide better insight into actual air leakage and changes in leakage over time, which may lead to a shorter length of hospital stay.Methods We performed a randomized controlled trial comparing the digital with analogue system, with theaim of demonstrating that use of a digital drainage system in PSP leads to a shorter hospital stay.Results In 102 patients enrolled with PSP we found no differences in total duration of chest tube drainageand hospital stay between the groups. However, in a post-hoc analysis, excluding 19 patients needing surgery due to prolonged air leakage, hospital stay was significantly shorter in the digital group (median 1 days, IQR 1-5 days) compared to the analogue group (median 3 days, IQR 2-5 days) (p 0.014). Treatment failure occurred in 3 patients in both groups; the rate of recurrence within 12 weeks was not significantly different between groups (16% in the digital group versus 8% in the analogue group, p 0.339).Conclusion Length of hospital stay was not shorter in patients with PSP when applying a digital drainage system compared to an analogue drainage system. However, in the large subgroup of uncomplicated PSP, a significant reduction in duration of drainage and hospital stay was demonstrated with digital drainage. These findings suggest that digital drainage may be a practical alternative to manual aspiration in the management of PSP. Trial registration: https://www.trialregister.nl/trial/4022. Registered 22 September 2013 - Retrospectively registered, Trial NL4022 (NTR4195)

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.

Right Superior Mediastinal Lymph Node Dissection in Thoracoscopic Surgery Using a Bipolar Sealing Device

2013 ◽  
Vol 8 (4) ◽  
pp. 258-263 ◽  
Author(s):  
Mitsuhiro Kamiyoshihara ◽  
Hitoshi Igai ◽  
Takashi Ibe ◽  
Natsuko Kawatani ◽  
Yoichi Ohtaki ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Learning Curve ◽  
Lymph Node Dissection ◽  
Thoracoscopic Surgery ◽  
Mediastinal Lymph Node ◽  
Mediastinal Lymph Node Dissection ◽  
Node Dissection ◽  
Chest Drainage ◽  
Sealing Device

Objective This study investigated the use of a new bipolar sealing device (BSD) in right superior mediastinal lymph node dissection during thoracoscopic surgery. Methods The study population consisted of 42 consecutive patients undergoing lobectomy with right superior mediastinal lymph node dissection for primary lung cancer. Operative results were compared with those of conventional surgery in 42 background-matched controls. The primary endpoint for the present analysis was the success of right superior mediastinal lymph node dissection during thoracoscopic surgery using a BSD. The secondary endpoints included the duration of the operation, number of dissected lymph nodes, chest drainage volume and duration, postoperative hospital stay, morbidity, and mortality. Results The BSD was used successfully in 42 patients. No significant difference in duration of lymph node dissection, chest drainage volume, drainage duration, or number of dissected lymph nodes was observed between the study group and the controls. Because of a learning curve, the procedure initially took more than 20 minutes to complete, but surgical time was reduced to approximately 15 minutes after the procedure was performed in 15 patients. Conclusions Our method is safe and in no way inferior to the conventional procedure. The tendency of the learning curve suggests that a significantly shorter duration of lymph node dissection is possible using this method.

scholarly journals Early experience with the Thopaz+ chest drainage system – is this a new era in the management of post-cardiotomy bleeding?

2021 ◽  
Vol 18 (4) ◽  
pp. 236-238
Author(s):  
Karolina Pawelkowska ◽  
Stanislaw Bartus ◽  
Robert Sobczynski ◽  
Michal Medrzycki ◽  
Grzegorz Grudzień ◽  
...  
Keyword(s):  
Drainage System ◽  
Early Experience ◽  
Chest Drainage ◽  
New Era

scholarly journals Institutional protocol to standardize the chest drainage system management, from surgery to nursing care, at a regional hospital in northern Paraná

2016 ◽  
Vol 38 (2) ◽  
pp. 173
Author(s):  
Amanda Carina Coelho de Morais ◽  
Maurício Medeiros Lemos ◽  
Vlaudimir Dias Marques ◽  
César Orlando Peralta Bandeira
Keyword(s):  
Prospective Observational Study ◽  
Drainage System ◽  
Pleural Space ◽  
Regional Hospital ◽  
System Management ◽  
Pleural Drainage ◽  
Chest Drainage ◽  
Drainage Time ◽  
Water Seal ◽  
Drainage Technique

The purpose of chest drainage is to allow lung re-expansion and the reestablishment of the subatmospheric pressure in the pleural space. Properly managing the drainage system minimizes procedure-related complications. This prospective observational study evaluated adult patients undergoing water-seal chest drainage, admitted to our hospital and accompanied by residents and tutors, aiming to check their care. One hundred chest drainages were monitored. The average age was 38.8 years old. The average drainage time was 6.7 days. Trauma was the prevalent cause (72%) for the indication of pleural drainage. The obstruction of the system occurred in 6% of the cases; 5% subcutaneous emphysema, 1% infection around the drain; 5% accidental dislodgement of the drain, and in 5% of the patients, there were some complications when removing the drain. Failures in chest drainage technique and management were present, and reflected in some complications that are inherent to the procedure, although it is known that there are intrinsic complications. This study aimed to assess the management of closed chest drainage systems and standardize the care provided in such procedure. 

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