ABSTRACT. 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.Keywords: chest drainage, chest tubes, thoracostomy, thoracic surgery.Protocolo institucional para padronizar cuidados com o dreno de tórax, desde a intervenção cirúrgica até os cuidados de enfermagem, em hospital regional do norte do Paraná RESUMO. O objetivo da drenagem torácica é possibilitar a reexpansão pulmonar e o restabelecimento da pressão subatmosférica no espaço pleural. O manejo adequado do sistema de drenagem minimiza as complicações relacionadas ao procedimento. O presente estudo observacional prospectivo avaliou pacientes adultos submetidos à drenagem torácica em selo d'água, internados em nosso hospital e acompanhados por médicos residentes e preceptores, com o objetivo de verificar o manejo com eles. Foram observadas 100 drenagens torácicas. A faixa etária média foi de 38,8 anos. O tempo médio de drenagem foi de 6,7 dias. Houve predomínio da causa traumática (72%) na indicação de drenagem pleural. A obstrução do sistema esteve presente em 6% dos casos; em 5%, houve enfisema subcutâneo; em 1%, infecção peridreno; em 5%, deslocamento acidental do dreno e, em 5% dos pacientes, houve complicação na retirada do dreno. Falhas na técnica e no manejo de drenagem torácica estão presentes em nosso serviço, refletidas em algumas complicações inerentes ao procedimento, embora saibamos que haja complicações que lhe são intrínsecas. O objetivo do estudo foi avaliar o manejo dos sistemas de drenagem torácica fechada e padronizar o protocolo para os cuidados com esse procedimento.
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