Thorac Cardiovasc Surg 2014; 62(06): 509-515
DOI: 10.1055/s-0033-1359714
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Efficacy Assessment of the Drainage with Permanent Airflow Measurement in the Treatment of Pneumothorax with Air Leak

Slawomir Jablonski
1   Department of Thoracic Surgery, General and Oncological Surgery, Medical University of Łódź, 113 Żeromskiego Street, 90-549 Łódź, Poland
,
Marian Brocki
1   Department of Thoracic Surgery, General and Oncological Surgery, Medical University of Łódź, 113 Żeromskiego Street, 90-549 Łódź, Poland
,
Marcin Wawrzycki
1   Department of Thoracic Surgery, General and Oncological Surgery, Medical University of Łódź, 113 Żeromskiego Street, 90-549 Łódź, Poland
,
Jacek Arkadiusz Smigielski
1   Department of Thoracic Surgery, General and Oncological Surgery, Medical University of Łódź, 113 Żeromskiego Street, 90-549 Łódź, Poland
,
Marcin Kozakiewicz
2   Department of Maxillofacial Surgery, Medical University of Łódź, 113 Żeromskiego Street, 90-549 Łódź, Poland
› Author Affiliations
Further Information

Publication History

27 August 2013

27 September 2013

Publication Date:
02 December 2013 (online)

Abstract

Aim The aim of this study was to compare the efficacy of the treatment of patients with spontaneous pneumothorax with air leak (AL) using two different chest drainage systems.

Methods Patients were randomized into two groups: group A included 30 patients (23 males and 7 females, mean age 41.1 ± 16.29 y, range 17–71 y) in which digital drainage system was used, group B with 30 patients (22 males and 8 females, mean age 40.3 ± 15.74 y, range 18–72 y) in which traditional suction drainage system was applied.

The following variables were evaluated: intensity of AL, duration of the chest tube drainage, delay in surgery, length of stay, and the overall hospitalization costs.

Results In group A the mean drainage duration was 47.63 hours, the hospitalization time was about 5.10 days, and the cost of hospitalization was €1,495. In group B the mean drainage duration was 84.93 hours, the hospitalization time was 6.97 days, and the hospitalization cost was €1,925.

Conclusion The digital drainage system applied in the treatment of AL in patients with pneumothoraces reduced the duration of the drainage, the length of hospital stay, and overall hospitalization costs.

 
  • References

  • 1 Noppen M. Spontaneous pneumothorax: epidemiology, pathophysiology and cause. Eur Respir Rev 2010; 19 (117) 217-219
  • 2 Sahn SA, Heffner JE. Spontaneous pneumothorax. N Engl J Med 2000; 342 (12) 868-874
  • 3 Chan WM J. Management of spontaneous pneumothorax. The Hong Kong Medical Diary Medical Bulletin 2007; 12 (1) 11-12
  • 4 Baumann MH, Strange C, Heffner JE , et al; AACP Pneumothorax Consensus Group. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest 2001; 119 (2) 590-602
  • 5 MacDuff A, Arnold A, Harvey J ; BTS Pleural Disease Guideline Group. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010; 65 (Suppl. 02) ii18-ii31
  • 6 Noppen M, Alexander P, Driesen P, Slabbynck H, Verstraeten A. Manual aspiration versus chest tube drainage in first episodes of primary spontaneous pneumothorax: a multicenter, prospective, randomized pilot study. Am J Respir Crit Care Med 2002; 165 (9) 1240-1244
  • 7 Ayed AK, Chandrasekaran C, Sukumar M. Aspiration versus tube drainage in primary spontaneous pneumothorax: a randomised study. Eur Respir J 2006; 27 (3) 477-482
  • 8 Packham S, Jaiswal P. Spontaneous pneumothorax: use of aspiration and outcomes of management by respiratory and general physicians. Postgrad Med J 2003; 79 (932) 345-347
  • 9 Chan SS, Lam PK. Simple aspiration as initial treatment for primary spontaneous pneumothorax: results of 91 consecutive cases. J Emerg Med 2005; 28 (2) 133-138
  • 10 Marquette C-H, Marx A, Leroy S , et al; Pneumothorax Study Group. Simplified stepwise management of primary spontaneous pneumothorax: a pilot study. Eur Respir J 2006; 27 (3) 470-476
  • 11 Ryu KM, Seo PW, Park S, Ryu JW. Complete atelectasis of the lung in patients with primary spontaneous pneumothorax. Ann Thorac Surg 2009; 87 (3) 875-879
  • 12 Filosso PL, Ruffini E, Solidoro P , et al. Digital air leak monitoring after lobectomy for primary lung cancer in patients with moderate COPD: does a fast-tracking algorithm can reduce postoperative costs and complications?. J Cardiovasc Surg (Torino) 2010; 51 (13) 1-5
  • 13 Rathinam S, Bradley A, Cantlin T, Rajesh PB. Thopaz Portable Suction Systems in Thoracic Surgery: an end user assessment and feedback in a tertiary unit. J Cardiothorac Surg 2011; 6: 59
  • 14 Varela G, Jiménez MF, Novoa NM, Aranda JL. Postoperative chest tube management: measuring air leak using an electronic device decreases variability in the clinical practice. Eur J Cardiothorac Surg 2009; 35 (1) 28-31
  • 15 Rhea JT, DeLuca SA, Greene RE. Determining the size of pneumothorax in the upright patient. Radiology 1982; 144 (4) 733-736
  • 16 Cerfolio RJ, Bryant AS. The quantification of postoperative air leaks. MMCTS 2009; (0409): mmcts.2007.003129 doi: 10.1510/mmcts.2007.003129.
  • 17 Zehtabchi S, Rios CL. Management of emergency department patients with primary spontaneous pneumothorax: needle aspiration or tube thoracostomy?. Ann Emerg Med 2008; 51 (1, I ) 91-100 , e1
  • 18 Henry M, Arnold T, Harvey J ; Pleural Diseases Group, Standards of Care Committee, British Thoracic Society. BTS guidelines for the management of spontaneous pneumothorax. Thorax 2003; 58 (Suppl. 02) ii39-ii52
  • 19 Melton 3rd LJ, Hepper NG, Offord KP. Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974. Am Rev Respir Dis 1979; 120 (6) 1379-1382
  • 20 Noppen M, Schramel F. Pneumothorax. Eur Respir Mon 2002; 22: 279-296
  • 21 Light RW. Management of spontaneous pneumothorax. Am Rev Respir Dis 1993; 148 (1) 245-248
  • 22 Baumann MH, Strange C, Heffner JE , et al; AACP Pneumothorax Consensus Group. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest 2001; 119 (2) 590-602
  • 23 Noppen M. Management of primary spontaneous pneumothorax: does cause matter?. Monaldi Arch Chest Dis 2001; 56 (4) 344-348
  • 24 Janssen J, Cardillo G. Primary spontaneous pneumothorax: towards outpatient treatment and abandoning chest tube drainage. Respiration 2011; 82 (2) 201-203
  • 25 Mathur R, Cullen J, Kinnear WJ, Johnston ID. Time course of resolution of persistent air leak in spontaneous pneumothorax. Respir Med 1995; 89 (2) 129-132
  • 26 Liberman M, Muzikansky A, Wright CD , et al. Incidence and risk factors of persistent air leak after major pulmonary resection and use of chemical pleurodesis. Ann Thorac Surg 2010; 89 (3) 891-897 , discussion 897–898
  • 27 Brunelli A, Xiume F, Al Refai M, Salati M, Marasco R, Sabbatini A. Air leaks after lobectomy increase the risk of empyema but not of cardiopulmonary complications: a case-matched analysis. Chest 2006; 130 (4) 1150-1156
  • 28 Mier JM, Fibla JJ, Molins L. The benefits of digital thoracic drainage system for outpatients undergoing pulmonary resection surgery. Rev Port Pneumol 2011; 17 (5) 225-227
  • 29 Cerfolio RJ, Minnich DJ, Bryant AS. The removal of chest tubes despite an air leak or a pneumothorax. Ann Thorac Surg 2009; 87 (6) 1690-1694 , discussion 1694–1696
  • 30 Cardillo G, Facciolo F, Giunti R , et al. Videothoracoscopic treatment of primary spontaneous pneumothorax: a 6-year experience. Ann Thorac Surg 2000; 69 (2) 357-361 , discussion 361–362
  • 31 Chee CB, Abisheganaden J, Yeo JK , et al. Persistent air-leak in spontaneous pneumothorax—clinical course and outcome. Respir Med 1998; 92 (5) 757-761
  • 32 Schramel FM, Postmus PE, Vanderschueren RG. Current aspects of spontaneous pneumothorax. Eur Respir J 1997; 10 (6) 1372-1379
  • 33 Tschopp JM, Rami-Porta R, Noppen M, Astoul P. Management of spontaneous pneumothorax: state of the art. Eur Respir J 2006; 28 (3) 637-650
  • 34 Almind M, Lange P, Viskum K. Spontaneous pneumothorax: comparison of simple drainage, talc pleurodesis, and tetracycline pleurodesis. Thorax 1989; 44 (8) 627-630
  • 35 Massard G, Thomas P, Wihlm JM. Minimally invasive management for first and recurrent pneumothorax. Ann Thorac Surg 1998; 66 (2) 592-599
  • 36 Brunelli A, Beretta E, Cassivi SD , et al. Consensus definitions to promote an evidence-based approach to management of the pleural space. A collaborative proposal by ESTS, AATS, STS, and GTSC. Eur J Cardiothorac Surg 2011; 40 (2) 291-297