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)

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.

Granulomatosis with polyangiitis of the skin induced by a chest drainage tube

2013 ◽  
Vol 23 (4) ◽  
pp. 565-567
Author(s):  
Chieko Ueda ◽  
Teruhiko Makino ◽  
Megumi Mizawa ◽  
Osamu Norisugi ◽  
Tadamichi Shimizu
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Drainage Tube ◽  
Chest Drainage ◽  
Chest Drainage Tube

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 Study on Chest Drainage Tube Fixation

2005 ◽  
Vol 41 (Supplement) ◽  
pp. 98-99
Author(s):  
Machiko Naito ◽  
Kazuhiko Shinohara
Keyword(s):  
Drainage Tube ◽  
Chest Drainage ◽  
Chest Drainage Tube

scholarly journals The application analysis of 8F ultrafine chest drainage tube for thoracoscopic lobectomy of lung cancer

2020 ◽  
Author(s):  
Yongbin Song ◽  
Chong Zheng ◽  
Shaohui Zhou ◽  
Hongshang Cui ◽  
Jincong Wang ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Hospital Stay ◽  
Drainage Tube ◽  
Chest Drainage ◽  
Drainage Volume ◽  
Thoracoscopic Lobectomy ◽  
Drainage Time ◽  
Chest Drainage Tube ◽  
Group A ◽  
Group B

Abstract Background Currently, thoracoscopic lobectomy is widely used in clinical practice, and postoperative placement of ultrafine drainage tube has advantages of reducing postoperative pain and accelerating postoperative recovery in patients. This study aimed to investigate the feasibility and safety of placement of 8F ultrafine chest drainage tube after thoracoscopic lobectomy and its superiority over traditional 24F chest drainage tube. Methods A retrospective data analysis was conducted in 134 patients who underwent placement of 8F ultrafine chest drainage tube or 24F chest drainage tube with thoracoscopic lobectomy for lung cancer from January 2018 to December 2019. Patients with 8F ultrafine chest drainage tube were included in group A (n = 67) and those with 24F chest drainage tube were included in group B (n = 67). The drainage time, the total drainage volume, postoperative hospital stay, postoperative pain score and postoperative complication of both groups were analyzed and compared. Results Compared to group B, group A had lower pain scores on postoperative days 1, 2 and 3 (3.72 ± 0.65point vs 3.94 ± 0.67point, P = 0.027; 2.72 ± 0.93point vs 3.13 ± 1.04point, P = 0.016; and 1.87 ± 0.65point vs 2.39 ± 1.22point, P = 0.005), shorter drainage time (4.25 ± 1.79d vs 6.04 ± 1.96d, P = 0.000), fewer drainage volume (1100.42 ± 701.57 ml vs 1369.39 ± 624.25 ml, P = 0.021); and shorter postoperative hospital stay (8.46 ± 2.48d vs 9.37 ± 1.70d, P = 0.014). Postoperative complications such as subcutaneous emphysema, pulmonary infection, atelectasis, chest tube reinsertion and intrathoracic hemorrhage showed no differences between both groups (P > 0.05). Conclusion Compared with 24F chest drainage tube, the application of an 8F ultrafine chest drainage tube after thoracoscopic lobectomy has significantly shortened the drainage time, reduced the total drainage volume, reduced the postoperative pain degree, shortened the hospital day, and effectively detected postoperative intrathoracic hemorrhage. So, it is considered as an effective, safe and reliable drainage method.

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

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.

scholarly journals The application analysis of 8F ultrafine chest drainage tube in thoracoscopic lobectomy for lung cancer

2020 ◽  
Author(s):  
Yongbin Song ◽  
Chong Zheng ◽  
Shaohui Zhou ◽  
Hongshang Cui ◽  
Jincong Wang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Postoperative Hospital Stay ◽  
Drainage Tube ◽  
Chest Drainage ◽  
Drainage Volume ◽  
Thoracoscopic Lobectomy ◽  
Drainage Time ◽  
Chest Drainage Tube

Abstract Background：Currently, thoracoscopic lobectomy is widely used in clinical practice, and postoperative placing of ultrafine drainage tube has advantages in reducing postoperative pain and accelerating postoperative recovery of patients.This study aim to investigate the feasibility and safety of placing 8F ultrafine chest drainage tube after thoracoscopic lobectomy and its superiority over traditional 24F chest drainage tube.Methods: A retrospective data analysis was undertaken on 134 patients who placed 8F ultrafine chest drainage tube or 24F chest drainage tube with thoracoscopic lobectomy for lung cancer from January 2018 to December 2019 by our surgical team.Patients divided into Group A（n=67）with 8F ultrafine chest drainage tube and Group B（n=67）with 24F chest drainage tube.The drainage time, the total drainage volume,postoperative hospital stay,postoperative pain score and postoperative complication of both groups were compared.Results: Compared to B group,the A group had lower pain scores on postoperative days 1,2 and 3(3.72±0.65point vs 3.94±0.67point,P=0.027 ;2.72±0.93point vs 3.13±1.04point,P=0.016;1.87±0.65point vs 2.39±1.22point,P=0.005),shorter drainage time(4.25±1.79d vs 6.04±1.96d,P=0.000),fewer drainage volume(1100.42±701.57ml vs 1369.39±624.25ml,P=0.021);shorter postoperative hospital stay(8.46±2.48d vs 9.37±1.70d,P=0.014).Postoperative complication such as subcutaneous emphysema,pulmonary infection,atelectasis,chest tube reinsertion and intrathoracic hemorrhage displayed no difference between both group as well(P >0.05).Conclusion:Compared with 24F chest drainage tube, the application of 8F ultrafine chest drainage tube after thoracoscopic lobectomy can significantly shorten the drainage time,reduce the total drainage volume,reduce the postoperative pain degree,shorten the hospital day,and effectively detect postoperative intrathoracic hemorrhage. It is an effective, safe and reliable drainage method.

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.

Effects of position of chest drainage tube on volume drained and pressure

1999 ◽  
Vol 8 (5) ◽  
pp. 319-323 ◽  
Author(s):  
JO Schmelz ◽  
D Johnson ◽  
JM Norton ◽  
M Andrews ◽  
PA Gordon
Keyword(s):  
Repeated Measures ◽  
Volume Of Fluid ◽  
Pleural Space ◽  
Drainage Tube ◽  
Chest Drainage ◽  
Entire Study ◽  
Repeated Measures Design ◽  
Chest Drainage Tube ◽  
Significant Difference ◽  
Difference Test

BACKGROUND: The nursing practice of avoiding dependent loops in the tubing of chest drainage systems because such loops may impede drainage and alter the intrapleural pressure is not research based. OBJECTIVES: To determine if the volume of fluid drained and pressure vary when the chest drainage tubing is straight, coiled, has a dependent loop, or has a dependent loop that is periodically lifted and drained. METHODS: A repeated-measures design was used. For each tubing position, 500 mL of fluid was infused into the pleural space of 8 adult pigs during 45 minutes. The volume of fluid drained and the pressure at 2 locations within the drainage tubing were measured for 1 hour. RESULTS: After 60 minutes, significantly less fluid (least significant difference test, P = .03) was drained with the dependent-loop tubing position (65 mL) than with the other 3 positions. However, the amount of fluid drained was not significantly different among the lift and drain (250 mL), coiled (301 mL), or straight (337 mL) tubing positions. Throughout the entire study, pressure at the connection between the chest tube and the drainage tube was significantly higher (least significant difference test, P = .003) for the dependent loop with and without periodic lifting and draining. CONCLUSIONS: Straight and coiled tube positions are optimal for draining fluid from the pleural space. If a dependent loop cannot be avoided, lifting and draining it every 15 minutes will maintain adequate drainage.

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