Advantages of applying digital chest drainage system for postoperative management of patients following pulmonary resection: a systematic review and meta-analysis of 12 randomized controlled trials

Zhou, Liying; Guo, Kangle; Shang, Xue; Fenfen, E; Xu, Meng; Wu, Yanan; Yang, Kehu; Li, Xiuxia

doi:10.1007/s11748-022-01875-7

Cited by 4 publications

(4 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Marulli et al aimed to further clarify these aspects by comparing electronic and traditional systems in a multicenter trial, focusing on interobserver variability and the differentiation of active air leaks from pleural space effects [60]. Finally, Zhou et al and Lee et al suggested that the DCD system primarily offers benefits in reducing the duration of chest tube placement, shortening hospital stays, determining the optimal timing of chest tube removal and therefore decreasing the frequency of chest tube clamping tests, but future studies should investigate the practical and financial implications of routinely implementing digital systems in clinical settings [61,62]. Overall, these studies suggest that while digital chest drainage systems offer several advantages, including more precise monitoring and potentially reduced hospital stays, their effectiveness and utility can vary based on the surgical and patient-specific contexts.…”

Section: Observation and Digital Air Leak Monitoringmentioning

confidence: 99%

Advancements in the Management of Postoperative Air Leak following Thoracic Surgery: From Traditional Practices to Innovative Therapies

Leivaditis,

Skevis,

Mulita

et al. 2024

Medicina

View full text Add to dashboard Cite

Background: Postoperative air leak (PAL) is a frequent and potentially serious complication following thoracic surgery, characterized by the persistent escape of air from the lung into the pleural space. It is associated with extended hospitalizations, increased morbidity, and elevated healthcare costs. Understanding the mechanisms, risk factors, and effective management strategies for PAL is crucial in improving surgical outcomes. Aim: This review seeks to synthesize all known data concerning PAL, including its etiology, risk factors, diagnostic approaches, and the range of available treatments from conservative measures to surgical interventions, with a special focus on the use of autologous plasma. Materials and Methods: A comprehensive literature search of databases such as PubMed, Cochrane Library, and Google Scholar was conducted for studies and reviews published on PAL following thoracic surgery. The selection criteria aimed to include articles that provided insights into the incidence, mechanisms, risk assessment, diagnostic methods, and treatment options for PAL. Special attention was given to studies detailing the use of autologous plasma in managing this complication. Results: PAL is influenced by a variety of patient-related, surgical, and perioperative factors. Diagnosis primarily relies on clinical observation and imaging, with severity assessments guiding management decisions. Conservative treatments, including chest tube management and physiotherapy, serve as the initial approach, while persistent leaks may necessitate surgical intervention. Autologous plasma has emerged as a promising treatment, offering a novel mechanism for enhancing pleural healing and reducing air leak duration, although evidence is still evolving. Conclusions: Effective management of PAL requires a multifaceted approach tailored to the individual patient’s needs and the specifics of their condition. Beyond the traditional treatment approaches, innovative treatment modalities offer the potential to improve outcomes for patients experiencing PAL after thoracic surgery. Further research is needed to optimize treatment protocols and integrate new therapies into clinical practice.

show abstract

Section: Observation and Digital Air Leak Monitoringmentioning

confidence: 99%

Advancements in the Management of Postoperative Air Leak following Thoracic Surgery: From Traditional Practices to Innovative Therapies

Leivaditis,

Skevis,

Mulita

et al. 2024

Medicina

View full text Add to dashboard Cite

show abstract

“…This study showed that irrespective of X-ray findings spontaneous pneumothorax can be managed without drainage in an asymptomatic patient ( 24 ). Although, not within the power of this study, when taken in context of the ample literature supporting digital drainage systems ( 4 - 17 ), one could consider digital drainage systems may accurately rule out clinically significant air leaks that would lead to re-insertion of a drain if it was pre-maturely removed. The second which is one of the aims of this study is that volume of liquid drainage does not predict the occurrence of a symptomatic pleural effusion.…”

mentioning

confidence: 93%

“…The first randomized controlled trial (RCT) reporting clinical outcomes from implementation of digital chest drainage systems were reported in 2008 ( 4 ). Since then 11 more studies ( 5 - 15 ) and two meta-analyses ( 16 , 17 ) have been conducted to evaluate the effectiveness of these devices. The data in the literature has shown some discrepancies, but as is intuitive, digital chest drainage systems show a decreasing duration of chest drain and length of stay but do not reduce duration of air leak.…”

mentioning

confidence: 99%

Contributing to Drainology: removing chest drains after pulmonary resection based on air leak alone

French

2023

J Thorac Dis

View full text Add to dashboard Cite

“…These systems provide a digital measurement of both fluid output and air leak, are reusable, and often do not require wall attachment for externally applied suction ( 6 ). In several observational studies and a recent meta-analysis, the use of a DCDS has been associated with a shorter duration of chest tube placement and reduced length of stay (LOS) ( 4 , 7 - 14 ). This may be due to increased confidence in the interpretation of air leaks and subsequent decrease in clinical practice variability ( 15 , 16 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes and staff satisfaction after adoption of digital chest drainage system for minimally invasive lung resections

Palleiko,

Singh,

Strader

et al. 2024

J Thorac Dis

View full text Add to dashboard Cite

Background Digital chest drainage systems (DCDS) provide reliable pleural drainage while quantifying fluid output and air leak. However, the benefits of DCDS in the contemporary era of minimally invasive thoracic surgery and enhanced recovery after surgery (ERAS) protocols have not been fully investigated. Additionally, hospital and resident staff experiences after implementation of a DCDS have not been fully explored. The objective of this study was to evaluate the clinical outcomes and hospital staff experience after adoption of a DCDS for minimally invasive lung resections. Methods A single-center retrospective review of patients who underwent minimally invasive lung resection (lobectomy, segmentectomy, and wedge resection) and received a DCDS from 11/1/2021 to 11/1/2022. DCDS patients were compared to sequential historical controls (3/1/2019–6/30/2021) who received a analog chest drainage system. For the analog system, chest tubes were removed when no bubbles were observed in the water seal compartment with Valsalva, cough, and in variable positions. With a DCDS, chest tubes were removed when the air leak was less than 30 cc/min for 8 hours, with no spikes. All patients followed an institutional ERAS protocol. Primary outcomes were length of stay (LOS) and chest tube duration. Hospital staff and residents were surveyed regarding their experience. Results One hundred and twenty-four patients received DCDS, and 248 received an analog chest drainage system. There was a reduction in mean LOS (3.6 vs . 4.4 days, P=0.01) and chest tube duration (2.7 vs . 3.6 days, P=0.03) in the DCDS group. Hospital staff (n=77, 46% response rate) reported the DCDS easier to use (60%, P<0.001) and easier to care for patients with (65%, P<0.001) compared to the analog system. Surgical residents (n=28, 56% response rate) reported increased confidence in interpretation of air leak (75%, P<0.001) and decision-making surrounding chest tube removal (79%, P<0.001). Conclusions Using a DCDS can reduce LOS and chest tube duration in the contemporary setting of minimally invasive lung resections and ERAS protocols. Increased confidence of resident decision-making for chest tube removal may contribute to improved outcomes.

show abstract

Advantages of applying digital chest drainage system for postoperative management of patients following pulmonary resection: a systematic review and meta-analysis of 12 randomized controlled trials

Cited by 4 publications

References 31 publications

Advancements in the Management of Postoperative Air Leak following Thoracic Surgery: From Traditional Practices to Innovative Therapies

Advancements in the Management of Postoperative Air Leak following Thoracic Surgery: From Traditional Practices to Innovative Therapies

Contributing to Drainology: removing chest drains after pulmonary resection based on air leak alone

Clinical outcomes and staff satisfaction after adoption of digital chest drainage system for minimally invasive lung resections

Contact Info

Product

Resources

About