A Systematic Review of Digital vs Analog Drainage for Air Leak After Surgical Resection or Spontaneous Pneumothorax

Aldaghlawi, Fadi; Kurman, Jonathan S.; Lilly, Jason A.; Hogarth, D. Kyle; Donington, Jessica S.; Ferguson, Mark K.; Murgu, Septimiu

doi:10.1016/j.chest.2019.11.046

Cited by 22 publications

(14 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For chest tube removal, we mainly judged the removal threshold by direct inspection of air bubbles in the water-seal chamber and recorded drainage volume based on traditional drainage system. Additionally, the digital chest drainage, a newly chest drainage system, could be used to guide chest tube removal ( 29 ). Digital drainage system was applied only in a few regions with high healthcare expenditure, while traditional drainage system was more widely used ( 3 ).…”

Section: Discussionmentioning

confidence: 99%

Suction Versus Nonsuction Drainage After Uniportal Video-Assisted Thoracoscopic Surgery: A Propensity Score-Matched Study

Zhou

Zheng

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

BackgroundUniportal video-assisted thoracoscopic surgery (UniVATS) was utilized with a rapid growth. The evidence is sparse, however, on whether to add external suction to water-seal drainage for chest drainage after UniVATS. This retrospective propensity score-matched study aimed to identify the necessity of adding external suction to chest drainage after UniVATS.MethodsPatients with lung cancer who underwent UniVATS were included from our prospectively maintained database. Patients were divided into two cohorts based on the addition of external suction to postoperative water-seal drainage or not. Propensity score-matched analysis was performed to identify the impact of suction on chest tube duration, incidence of persistent air leak, hospital stay, and hospitalization cost. Multivariable model with interaction terms was constructed to identify impact of covariables on effect of suction.ResultsThe two cohorts matched well on baseline characteristics (nonsuction: 173; suction: 96). Compared with nonsuction group, suction group showed longer median chest tube duration (3 vs. 2 days, p = 0.003), higher incidences of persistent air leak (9.4% vs. 1.2%, p = 0.003), persistent drainage (16.8% vs. 5.8%, p = 0.007), and reduced drainage volume within first 3 postoperative days (386.90 vs. 504.78 ml, p = 0.011). Resection extent was identified to mediate the relationship between suction and chest tube drainage.ConclusionsThese findings discouraged adding external suction to water-seal drainage after UniVATS regarding longer chest tube duration and more persistent air leak. Patients undergoing lobectomy would benefit more from water-seal drainage without external suction compared with those doing sublobectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

Suction Versus Nonsuction Drainage After Uniportal Video-Assisted Thoracoscopic Surgery: A Propensity Score-Matched Study

Zhou

Zheng

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…The clinically appropriate threshold flow of air leak flow for chest tube removal differs substantially across trials, but reported levels generally range from 0 to 50 mL/min over a period of 1-12 hours prior to removal (8,15). In this study, we utilized 20 mL/min as prompting consideration for chest tube removal.…”

Section: Discussionmentioning

confidence: 99%

Use of a novel digital drainage system after pulmonary resection

Geraci¹,

Sorensen²,

James³

et al. 2022

J Thorac Dis

View full text Add to dashboard Cite

Background: The Thoraguard Surgical Drainage System is a novel device for drainage of air and fluid after cardiothoracic surgery.Methods: A three-part study was conducted: a prospective observational safety and feasibility study, a retrospective comparison of patients managed with an analogue drainage system, and a clinician userfeedback survey.Results: Fifty patients underwent robotic pulmonary resection utilizing the Thoraguard system for postoperative drainage. The Thoraguard system detected a higher number of air leaks than an analogue system (36/50, 72% vs. 45/200, 23%; P<0.001) and was associated with decreased chest tube duration of 1 day [interquartile range (IQR) 0-2] vs. 2 days (IQR 2-3) (P=0.042) and hospital length of stay of 2 days (IQR 2-3) vs. 3 days (IQR 2-4) (P=0.027). Patients with a peak air leak less than 100 mL/min (32 patients, 64%), had a decreased median chest tube duration of 1 day (IQR 0-1) vs. 2.8 days (IQR 1-3) (P=0.004). Compared to an analogue system, the Thoraguard system had superior user-reported ability to detect air-leaks (17/23, 74%), better ease of patient ambulation (14/23, 61%), and better display of clinically relevant information (22/23, 96%). Conclusions:The Thoraguard Surgical Drainage System provides safe and effective drainage post pulmonary resection. Compared to an analogue system, the Thoraguard system detected a higher number of air leaks and was associated with decreased chest tube duration and hospital length of stay. User survey data reported superior air leak detection, display of clinical data, and ease of use of the Thoraguard system.

show abstract

“…Data have shown that a tube thoracostomy can be safely removed once an air leak is <20 mL/min (5). Utilization of a digital drainage device permits earlier removal of a pleural drain, which in turn decreases hospital length of stay (LOS) (6)(7)(8). These units will undoubtedly become more commonplace as affordability improves.…”

Section: Classification Of Severitymentioning

confidence: 99%

“…Duration refers to how long the leak has been present. Volume refers to the degree of leak, which can be assessed using an analog or digital collection system (6). Put simply, an air leak is less likely to spontaneously resolve if there is a large leak that has been present for a longer period of time and is getting worse (23).…”

Section: Treatmentmentioning

confidence: 99%

Persistent air leak management in critically ill patients

Kurman¹

2021

J Thorac Dis

Self Cite

View full text Add to dashboard Cite

This review article will clearly elucidate key definitions on this subject, discuss how to classify the severity of an air leak, briefly review PAL epidemiology, identify risk factors, examine guidelines, and explore treatment options. The discussion of treatment strategies will focus on those applicable to critically ill patients who are often not surgical candidates. Hence, surgical strategies will not be covered. DefinitionsPAL refers to the continued air flow from the endobronchial tree to the pleural space. The specific terminology applied to this pathologic communication depends on its origin. An alveolar pleural fistula refers to a connection between the subsegmental bronchus or a more distal portion of the

show abstract

A Systematic Review of Digital vs Analog Drainage for Air Leak After Surgical Resection or Spontaneous Pneumothorax

Abstract: Word Count: 252 Manuscript Word Count (excluding references): 2376 Conflict of Interest: All authors have no conflicts of interest.

Cited by 22 publications

References 40 publications

Suction Versus Nonsuction Drainage After Uniportal Video-Assisted Thoracoscopic Surgery: A Propensity Score-Matched Study

Suction Versus Nonsuction Drainage After Uniportal Video-Assisted Thoracoscopic Surgery: A Propensity Score-Matched Study

Use of a novel digital drainage system after pulmonary resection

Persistent air leak management in critically ill patients

Contact Info

Product

Resources

About