Dysfunctional Closed Chest Drainage - Common Causative Factors and Recommendations for Prevention

Abstract

IntroductionDysfunctional closed chest drainage unit (CDU) dysfunction is a common but serious clinical problem associated with tube thoracostomy and results in a significant rise in morbidity, prolonged hospital stays, and increased economic burden. This observational study examines the proximate factors of closed CDU dysfunction in addition to their relative frequency. Based on our findings, we suggest logical recommendations for preventing the factors that contribute to closed chest drainage unit dysfunction.MethodThe study target population consists of all those individuals who had experienced tube thoracostomy for any pathology related to the chest cavity treated in the Department of Thoracic Surgery, Nishter Medical University, Multan, Pakistan, from February 2015 to January 2017. The study population was not restricted by age or gender. Of the 727 examined cases, only those patients who had experienced tube thoracostomy and had significant failure in draining the pleural collection were included in the study. Detailed histories were collected, and thorough physical examinations were carried out for each participant. Chest x-rays and, if needed, computed tomography (CT) scans were obtained to properly examine the placement of the chest tubes and detect the causative factor of the closed CDU dysfunction.ResultsA total of 139 cases were included in the study. The most common cause of closed CDU dysfunction was the use of the wrong CDU connection (n = 24, 17.3%). Other common problems included inadequate prime fluid use, loose connections, kinked tubes, and overly full bottles.ConclusionClosed CDU dysfunction may be prevented by adopting and following proper protocols for tube thoracostomy.

Comparison between use of a pleural drainage system with flutter valve and a conventional water-seal drainage system after lung resection: a randomized prospective study

“…Previous studies have described inadequate connections, low volume of liquid in the bottle, loss of connection between the drain and the chest tube, kinks in the system’s connecting tube, inadequate clamping, blockage of the air output relief valve, failure in suction, and consequences of placement of the system above the level of the chest. 12 , 13 In our study, there was one dysfunction in the water-seal system: the patient, in a moment of confusion, emptied the collector, which led to lung collapse, prolonged air leak, and empyema.…”

Simulador de dreno de tórax: desenvolvimento de modelo de baixo custo para capacitação de médicos e estudantes de medicina.

“…In the question about how secure they felt in performing the procedure after the practical activity with the simulator, the scores were also similar for both groups, and, although the SMG presented a greater difference between the pre-and postpractice grades, there was no statistic significance between them, revealing that the simulator model may not be superior to the traditional animal model in the learning gain of the students, but it is equivalent. that poor positioning can result in non-adequate functioning and complications 16,17 .…”

Comparison of Morbidity Associated with the use of Large Versus Small-Bore Chest Tubes in Patients Managed for Stage-I Empyema Thoracis

“…8,9 Pakistan is a country where the complication rate of routine infections is high, and therefore, thoracic empyema cases are commonly encountered by clinicians. A recent local study by Hashmi et al 10 highlighted common causes of dysfunctional tubes and discussed various strategies to prevent this complication. Little is published about how the tube size could be associated with pain and other complications in patients with chest tubes.…”