Digital pleural versus analog drainage devices for postoperative management of patients after pulmonary resection

This work was designed to identify and summarize the current comparative data between digital pleural drainage devices and traditional analog pleural drainage devices in patients undergoing pulmonary resection. Outcomes of interest were hospital length of stay (LOS), chest tube duration, healthcare costs, incidence of prolonged air leak and patient and healthcare personnel satisfaction.

The PubMed and Web of Science databases were searched for randomized controlled trials (RCTs) and meta-analyses comparing outcomes between the use of digital and analog chest tube drainage devices.

Fourteen RCTs and 4 meta-analyses were identified. Eight RCTs found no difference in LOS or chest tube duration while 6 RCTs found a decrease in LOS and chest tube duration with digital devices. All the meta-analyses showed decreased LOS and chest tube duration with digital devices. Six out of 8 studies that compared the incidence of prolonged air leak showed no difference between digital and analog cohorts. Two RCTs and 1 meta-analysis reported decreased costs with digital systems. Two out of 3 RCTs reported improved patient and healthcare personnel satisfaction with digital systems while 1 RCT reported no difference.

While the data comparing length of stay and chest tube duration are mixed, the introduction of digital pleural drainage devices has provided a more objective assessment of air leak flow rates and potentially a more accurate assessment of the timing of air leak resolution after pulmonary resection. Further studies are needed to better delineate the cost utility and ideal scenarios for the use of digital devices.