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Related Experiment Videos

When to remove a chest tube? A randomized study with subsequent prospective consecutive validation.

Riad N Younes1, Jefferson L Gross, Samuel Aguiar

  • 1Department of Thoracic Surgery, Hospital do Câncer AC Camargo, São Paulo, SP, Brazil.

Journal of the American College of Surgeons
|November 20, 2002
PubMed
Summary

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Increasing chest tube drainage threshold to 200 mL/day for pleural fluid removal is safe and effective. This change in chest tube management did not impact drainage time, hospital stay, or reaccumulation rates.

Area of Science:

  • Thoracic Surgery
  • Pulmonary Medicine
  • Critical Care Medicine

Background:

  • Chest tube drainage is standard for pleural space procedures.
  • Current chest tube removal timing varies widely among surgeons.
  • Establishing a standardized drainage threshold is needed.

Purpose of the Study:

  • To evaluate the effectiveness and safety of a 200 mL/day drainage threshold for chest tube removal.
  • To compare this threshold against commonly used 100 mL/day and 150 mL/day thresholds.
  • To determine if a higher threshold impacts patient outcomes or reaccumulation rates.

Main Methods:

  • A prospective randomized study involved 139 patients undergoing pleural drainage.
  • Patients were randomized into groups with thresholds of <=100 mL/d, <=150 mL/d, or <=200 mL/d.

Related Experiment Videos

  • A validation group (91 patients) used a <=200 mL/d threshold.

    • Main Results:

    • No statistically significant differences in drainage time or hospital stay were observed across groups.
    • Radiologic reaccumulation rates and thoracentesis rates showed no major differences between the 100, 150, and 200 mL/d groups.
    • The 200 mL/d threshold demonstrated comparable safety and efficacy to lower thresholds.

    Conclusions:

    • Increasing the chest tube drainage threshold to 200 mL/day is a safe and effective practice.
    • This threshold does not significantly alter drainage duration, hospitalization, or reaccumulation rates.
    • The 200 mL/day threshold can be recommended for chest tube removal in cases of uninfected pleural fluid without air leaks.