PubMed · 8361690
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1993. Managing chest drainage problems.. https://pubmed.ncbi.nlm.nih.gov/8361690/
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OBJECTIVE: To evaluate the clinical efficacy of a new digital drainage system, the DigiVent Chest Drainage System that gives accurate measurements of air leakage and pleural pressures and can display those measurements over time. METHODS: The DigiVent Chest Drainage System was tested in three steps: Step 1; first clinical use in five patients, Step 2; management and acceptance in further 15 patients and Step 3; reliability in routine use in 50 patients. RESULT: The results from Steps 1 and 2 showed that the system was good enough for extended use. The results from Step 3 showed excellent clinical performance, however, we experienced device malfunctions in four cases without any consequences for the patients. The cause of the malfunctions was identified and steps taken to prevent their further occurrence. CONCLUSION: The ability of the DigiVent to measure airflow and present mean values for 1, 3 and 6h proved to be very practical. The ability to save data and present curves for the entire course of treatment will be an advantage for research in the field of lung surgery.
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PURPOSE: The necessity of a postoperative chest tube for the treatment of pneumothorax after a radical nephrectomy is controversial. MATERIALS AND METHODS: A five-year retrospective study was performed on 91 patients, having undergone a radical nephrectomy. We examined the existence and length of a pleural rent, presence of a postoperative thoracostomy tube, postoperative pneumothorax, postoperative pneumonia, postoperative atelectasis, pain scores, hemoglobin saturation, and length of hospital stay with univariate and multivariate analysis. RESULTS: Incidence of a pleural rent occurred in 29 (36%) of open radical nephrectomy cases; 4 of the 29 cases had a postoperative thoracostomy tube. There was no significant difference in hemoglobin saturation levels between cases that had no pleural rent, a pleural rent without a thoracostomy tube, and a pleural rent with a postoperative thoracostomy tube. A pleural rent without a postoperative chest tube had significantly lower rates of pain score, atelectasis, pneumonia, pleural effusion, and length of hospital stay compared to individuals with a postoperative chest tube. Patients with a chest tube had a significantly higher incidence of pain, atelectasis, pneumonia, effusion, and length of hospital stay. CONCLUSION: Iatrogenic pleural rents treated without a postoperative chest tube show a significant decrease in postoperative complications of pneumonia and atelectasis, pain score and length of hospital stay. These patients show no significant increases in postoperative complications; therefore, it appears that postoperative chest tube placement after a pleural injury occurs is of no advantage.