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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
Volume threshold for chest tube removal: a randomized controlled trial.
Mohammad Ali Hessami1, Farid Najafi, Sajad Hatami
1Department of Surgery, Kermanshah University of Medical Sciences, Iran. mahessami@hotmail.com
Journal of Injury & Violence Research
|April 13, 2011
Summary
Removing chest tubes when daily drainage reaches 200 ml, compared to 150 ml, is safe and effective. This approach leads to a shorter hospital stay and potentially reduces healthcare costs.
Area of Science:
- Thoracic Surgery
- Trauma Management
- Critical Care Medicine
Background:
- Chest tube insertion is crucial for managing chest trauma and malignancy.
- Optimal criteria for chest tube removal, specifically daily drainage volume, lack consensus.
- This study investigates two distinct chest tube removal thresholds.
Purpose of the Study:
- To compare the safety and effectiveness of chest tube removal at 150 ml/day versus 200 ml/day.
- To evaluate clinical outcomes including reaccumulation, need for thoracentesis, and respiratory sounds.
- To assess the impact on length of hospital stay and associated costs.
Main Methods:
- Randomized controlled trial involving 138 patients requiring chest tube replacement.
- Patients were allocated to either a 150 ml/day (control) or 200 ml/day (trial) drainage removal group.
- Clinical outcomes were compared using chi-squared and t-tests, with a 7-day post-discharge follow-up.
Main Results:
- No statistically significant differences were observed in drainage time between groups (p=0.1).
- The 200 ml/day group demonstrated a significantly shorter mean length of hospital stay (4.1 vs. 4.8 days, p=0.04).
- Rates of radiological reaccumulation, thoracentesis, and decreased pulmonary sounds were comparable between groups.
Conclusions:
- Removing chest tubes at a daily drainage volume of 200 ml is as safe as the 150 ml/day threshold.
- The 200 ml/day removal strategy is associated with a shorter hospital stay.
- This finding suggests potential for reduced healthcare costs through earlier chest tube removal.
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