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

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Dieuwertje Ruigrok ◽  
Peter W. A. Kunst ◽  
Marielle M. J. Blacha ◽  
Ben Tomlow ◽  
Jacobine W. Herbrink ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Spontaneous Pneumothorax ◽  
Controlled Trial ◽  
Drainage System ◽  
Primary Spontaneous Pneumothorax ◽  
Chest Drainage ◽  
Randomized Controlled

scholarly journals Gravity Drainage Versus Forced Suction Drainage for Patients With Excess Fluid in Pleural or Peritoneal Spaces

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Yan Li ◽  
Charlene Argáez
Keyword(s):  
Lung Cancer ◽  
Hospital Stay ◽  
Chest Tube ◽  
Meta Analysis ◽  
Lung Cancer Surgery ◽  
Cancer Surgery ◽  
Gravity Drainage ◽  
Chest Drainage ◽  
Tube Drainage ◽  
Randomized Controlled

The evidence for chest drainage with gravity compared with forced suction was mixed. Two randomized controlled trials included in 2 systematic reviews with meta-analysis suggested that there is no difference between chest drainage with gravity versus forced suction regarding the risk of prolonged air leak, or post-operative pneumothorax and the duration of chest tube drainage, or hospital stay, following lung cancer surgery. However, 1 randomized controlled trial included in a systematic review with meta-analysis suggested that chest drainage with gravity resulted in a shorter duration of chest tube drainage and hospital stay compared to forced suction following lung cancer surgery. One guideline suggests that chest drainage with forced suction does not provide additional benefits for patients undergoing lung surgery compared to gravity drainage. There is a lack of relevant literature and guidelines on the clinical effectiveness or use of abdominal space drainage with gravity or forced suction.

scholarly journals “Enhanced recovery after surgery – ERAS in elective craniotomies-a non-randomized controlled trial”

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anirudh Elayat ◽  
Sritam S. Jena ◽  
Sukdev Nayak ◽  
R. N. Sahu ◽  
Swagata Tripathy
Keyword(s):  
Randomized Controlled Trial ◽  
Glycemic Control ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Controlled Trial ◽  
Early Recovery ◽  
Randomized Controlled ◽  
Pain Scores ◽  
High Dependency

Abstract Background Enhanced Recovery After Surgery (ERAS) is a multimodal perioperative care bundle aimed at the early recovery of patients. Well accepted in gastric and pelvic surgeries, there is minimal evidence in neurosurgery and neurocritical care barring spinal surgeries. We wished to compare the length of intensive care unit (ICU) or high dependency unit (HDU) stay of patients undergoing elective craniotomy for supratentorial neurosurgery: ERAS protocol versus routine care. The secondary objective was to compare the postoperative pain scores, opioid use, glycemic control, and the duration of postoperative hospital stay between the two groups. Methods In this pragmatic non-randomized controlled trial (CTRI/2017/07/015451), consenting adult patients scheduled for elective supratentorial intracranial tumor excision were enrolled prospectively after institutional ethical clearance and consent. Elements-of-care in the ERAS group were- Preoperative –family education, complex-carbohydrate drink, flupiritine; Intraoperative – scalp blocks, limited opioids, rigorous fluid and temperature regulation; Postoperative- flupiritine, early mobilization, removal of catheters, and initiation of feeds. Apart from these, all perioperative protocols and management strategies were similar between groups. The two groups were compared with regards to the length of ICU stay, pain scores in ICU, opioid requirement, glycemic control, and hospital stay duration. The decision for discharge from ICU and hospital, data collection, and analysis was by independent assessors blind to the patient group. Results Seventy patients were enrolled. Baseline demographics – age, sex, tumor volume, and comorbidities were comparable between the groups. The proportion of patients staying in the ICU for less than 48 h after surgery, the cumulative insulin requirement, and the episodes of VAS scores > 4 in the first 48 h after surgery was significantly less in the ERAS group – 40.6% vs. 65.7%, 0.6 (±2.5) units vs. 3.6 (±8.1) units, and one vs. ten episodes (p = 0.04, 0.001, 0.004 respectively). The total hospital stay was similar in both groups. Conclusion The study demonstrated a significant reduction in the proportion of patients requiring ICU/ HDU stay > 48 h. Better pain and glycemic control in the postoperative period may have contributed to a decreased stay. More extensive randomized studies may be designed to confirm these results. Trial registration Clinical Trial Registry of India (CTRI/2018/04/013247), registered retrospectively on April 2018.

scholarly journals Full versus Trophic Feeds in Critically Ill Adults with High and Low Nutritional Risk Scores: A Randomized Controlled Trial

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3518
Author(s):  
Chen-Yu Wang ◽  
Pin-Kuei Fu ◽  
Wen-Cheng Chao ◽  
Wei-Ning Wang ◽  
Chao-Hsiu Chen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Controlled Trial ◽  
Risk Scores ◽  
Nutrition Risk ◽  
Randomized Controlled ◽  
Trophic Feeding

Although energy intake might be associated with clinical outcomes in critically ill patients, it remains unclear whether full or trophic feeding is suitable for critically ill patients with high or low nutrition risk. We conducted a prospective study to determine which feeding energy intakes were associated with clinical outcomes in critically ill patients with high or low nutrition risk. This was an investigator-initiated, single center, single blind, randomized controlled trial. Critically ill patients were allocated to either high or low nutrition risk based on their Nutrition Risk in the Critically Ill score, and then randomized to receive either the full or the trophic feeding. The feeding procedure was administered for six days. No significant differences were observed in hospital, 14-day and 28-day mortalities, the length of ventilator dependency, or ICU and hospital stay among the four groups. There were no associations between energy and protein intakes and hospital, 14-day and 28-day mortalities in any of the four groups. However, protein intake was positively associated with the length of hospital stay and ventilator dependency in patients with low nutrition risk receiving trophic feeding. Full or trophic feeding in critically ill patients showed no associations with clinical outcomes, regardless of nutrition risk.

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