Practical Aspects About Closed Chest Drainage Care: A Literature Review

Abstract

| Context:The drained pleural contents may vary, as well as their drainage, however closed drainage system is the most frequent one and reaches flaws along those who are in charge of their management. Objetive: Provide a comprehensive review about close chest drainage. Methods: A systematic search of the PubMed and Medline databases was conducted on closed drainage system using the following keyword combination: chest tubes AND drainage. Results: From eight hundred eight-three articles retrieved after our preliminary search, 17 articles were chosen for final analysis. Representative schemes were drawn to better understanding of the three types of chest drainage systems for pleura effusion: (i) the closed drainage system; (ii) the open drainage system; and (iii) the suction drainage system. Representative pictures were also developed in order to facilitate additional care in the field. Conclusions: Bringing information together about chest tube management in closed drainage system may imply in a better approach to the patients, minimize institutional cost, minimize material waste and promote efficient communication among the multidisciplinary staff. Understanding details about tubular tube, pig tail tube, one-way bag, one-way valve and collectors is the only way to perform a better approach to the patient who needs closed drainage system.

Heimlich Valve as an Ambulation Management of Persistent Pneumothorax or Fluidopneumothorax

“…Meanwhile, the outlet nozzle of the Heimlich valve does not need to be connected to a drainage bag in pneumothorax or connected to the drainage bag in fluido-pneumothorax. 10,13 Before the patient is being discharged from the hospital, it is necessary to recheck the sutures in the chest tube insertion. If you feel that the sutures are not strong enough or loose, it can be sutured again with a non-absorbable suture.…”

“…Drainage bags also need to be replaced with new ones regularly, thus they will not become a source of infection. 10 Patients must be more careful in their activities.…”

“…Patients can come to the doctor outside their routine schedule if they experience high fever, intense feeling of tightness, chest pain, swelling of the neck or hands, pain that increases and does not go away by pain medication, the skin around the chest tube is red, swollen, or feels warm, painful to the touch, the amount of liquid from the collection bag increases, the liquid changes color or cloudy, and smells. 2,10,14…”