Predictors of outcome of chest tube drainage of nonpurulent exudative pleural effusions

Abstract

BackgroundChest tube drainage, though the primary management method for many pleural effusions has a failure rate of 9.4–48%. In this study, we examined the factors that predict the outcome of management of non-purulent exudative effusions.Study objectivesTo determine the predictors of outcomes of chest tube drainage of pleural effusions.MethodologyConsecutive patients who had a chest tube drainage of non-purulent exudative pleural effusions were followed up till extubation and discharge in a prospective observational cohort study. Data on the management of the patients were recorded, analyzed and compared between groups of patients with good and poor outcomes.ResultsOf the 52 patients studied, 38 had good outcomes while 14 had poor outcomes. The mean age was 39.7±15.9. Multivariate analysis demonstrated that empyema thoracis complicating drainage was an independent predictor of a poor outcome while the duration of drainage ≤14 days and duration of illness before presentation <30 days were predictive of a good outcome.ConclusionOur results show that the development of empyema thoracis during drainage, a long duration of drainage and a prolonged period of illness before presentation are predictive of the outcome of chest tube drainage.

Drenagem torácica:

“…Nesse caso, o exsudato é Drenagem torácica determinado por LDH no líquido pleural superior a 307 UI/L ou por colesterol no líquido pleural acima de 60 mg/dL. 10 É importante citar que os derrames pleurais transudativos por falência hepática ou outras causas sistêmicas não devem ser manejados primariamente com toracostomia, mas sim focar na causa base. 11 O procedimento apresenta como contraindicação absoluta apenas a falta de consentimento ou cooperação por parte do paciente.…”