Is Milking and Stripping Chest Tubes Really Necessary?

Lim-Levy, Fidelita; Babler, Shaye Anne; Groot-Kosolcharoen, Jane De; Kosolcharoen, Peter; Kroncke, George M.

doi:10.1016/s0003-4975(10)61841-3

Cited by 29 publications

(9 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The practice of chest drain stripping is also addressed in the adult literature, both in scientific research using adult male patients (Duncan & Erickson , Lim‐Levy et al . ) and in systematic literature reviews (Wallen et al . , Halm ).…”

Section: Introductionmentioning

confidence: 99%

Nurses' knowledge of chest drain management in an Irish Children's Hospital

Magner

Houghton

Craig

et al. 2013

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Nurses' knowledge of chest drain management in an Irish Children's Hospital

Magner

Houghton

Craig

et al. 2013

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…Halfway through the study, on nurses' and physicians' request, a soft silicone tube was inserted between the chest tubes and the Medela suction tube in order to allow for milking which is standard practice in many cardiac centres such as Verona [9]. However, the literature is controversial on this point and some studies come to the indication that manipulation such as milking of mediastinal chest drains does not show any improvement on drainage quantity or on outcome of patients [10,11].…”

Section: Discussionmentioning

confidence: 99%

Randomized Controlled Trial of a Novel, Digital, Chest Drainage System in Cardiac Surgery Patients

Barozzi¹,

Biagio²,

Meneguzzi³

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: A new, self-contained, digital, continuous pump-driven chest drainage system is compared for the first time in a Randomized Control Trial to a traditional wall-suction system in cardiac surgery.Methods: 120 adult elective cardiac patients undergoing CABG and/or valve surgery were randomized to the study or control group. Both groups had similar pre/intra-operative demographics: age 67.8 vs. 67.0 years, Euroscore 2.3 vs. 2.2 and BSA 1.92 vs. 1.91 m2. Additionally, a satisfaction assessment score was performed by 52 staff members.Results: Given homogenous intra-operative variables, total chest-tube drainage was comparable among groups (566 vs. 640 ml; ns), but the study group showed more efficient fluid collection during the early post-operative phase (p = 0.006 and p = 0.01) due to continuous suction compared to 11.5 minutes off-suction time in the control group. Blood, cell saver transfusions and post-operative hemoglobin values were similar in both groups. The study group experienced drain removal after 29.8 vs 38.4 hours in the control group (ns). Seven crossovers from the Study to the Control group were registered but no patient had drain-related complications.Conclusion: The new, self-contained, digital, continuous pump-driven drainage system showed better early drainage of the chest cavity and was as reliable as conventional systems. Quicker drain removal might impact on ICU stay and reduce costs. Additional advantages are portable size, battery operation, patient mobility, noiseless function, digital indications and alarms. The satisfaction assessment of the new system by the staff revealed a higher score when compared to the traditional wall suction chest drainage system. This Randomized Control Trial was retrospectively registered on June 7, 2019 under ISRCTN 14884587. https://doi.org/10.1186/ISRCTN14884587

show abstract

“…Lim Levy et al 51 compared stripping, milking, and no manipulation for 60 cardiac surgery patients and found no difference in tube occlusion when no manipulation was performed. Kirkwood 52 authored an "Ask the Expert" column in Critical Care Nurse regarding stripping versus milking chest tubes and concluded that both interventions "should be avoided" because they do not improve chest tube patency and may cause an undesired increase in intrathoracic pressures.…”

Section: Review Of Current Evidencementioning

confidence: 99%

Continuing to Challenge Practice to Be Evidence Based

Makic

Rauen

Jones

et al. 2015

Critical Care Nurse

View full text Add to dashboard Cite

E nsuring that we provide safe, evidence-based, cost-effective care to all patients is an assumption of today's health care system. All patients and health care providers should expect a health care system that is committed to preventing harm and improving patient care by having clinicians use evidence-based safe practices.1 The call for evidence-based practice (EBP) was made in the hallmark publication of the Institute of Medicine's report "To Err Is Human" more than a decade ago. Feature Practice habits continue in clinical practice despite the availability of research and other forms of evidence that should be used to guide critical care practice interventions. This article is based on a presentation at the 2014 National Teaching Institute of the American Association of Critical-Care Nurses. The article is part of a series of articles that challenge critical care nurses to examine the evidence guiding nursing practice interventions. Four common practice interventions are reviewed: (1) weight-based medication administration, (2) chest tube patency maintenance, (3) daily interruption of sedation, and (4) use of chest physiotherapy in children. For weight-based administration of medication, the patient's actual weight should be measured, rather than using an estimate. The therapeutic effectiveness and dosages of medications used in obese patients must be critically evaluated. Maintaining patency of chest tubes does not require stripping and milking, which probably do more harm than good. Daily interruption of sedation and judicious use of sedatives are appropriate in most patients receiving mechanical ventilation. Traditional chest physiotherapy does not help children with pneumonia, bronchiolitis, or asthma and does not prevent atelectasis after extubation. Critical care nurses are challenged to evaluate their individual practice and to adopt current evidence-based practice interventions into their daily practice. (Critical Care Nurse. 2015;35[2]:39-50)

show abstract

Is Milking and Stripping Chest Tubes Really Necessary?

Cited by 29 publications

References 2 publications

Nurses' knowledge of chest drain management in an Irish Children's Hospital

Nurses' knowledge of chest drain management in an Irish Children's Hospital

Randomized Controlled Trial of a Novel, Digital, Chest Drainage System in Cardiac Surgery Patients

Continuing to Challenge Practice to Be Evidence Based

Contact Info

Product

Resources

About