Retrospective analysis of the relationship between time of thoracostomy drain removal and discharge time

Marques, A.I.; Tattersall, J.; Shaw, Darren; Welsh, Elizabeth

doi:10.1111/j.1748-5827.2008.00694.x

Cited by 19 publications

(21 citation statements)

References 8 publications

(3 reference statements)

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“…No evidence of dyspnea was noted in any of the dogs at the time of discharge, even with a fluid production above 2 mL/kg/day. Fluid production in the pleural space varies greatly, as a result of factors such as size of the thoracostomy tube, the nature of the tube and the disease process present in the thoracic cavity . In this study, all dogs underwent lung lobectomy for either a primary lung tumor or metastatic lung disease.…”

Section: Discussionmentioning

confidence: 99%

“…At the time of the removal of the thoracostomy tube, the volume of fluid produced was higher than the 2 mL/kg/day recommended in the literature. [26][27][28] Marques et al 28 reported neither fluid production above 2 mL/kg/day at the time of thoracostomy tube removal, nor the amount of fluid at the time of removal, to be associated with complications. No evidence of dyspnea was noted in any of the dogs at the time of discharge, even with a fluid production above 2 mL/kg/day.…”

Section: Discussionmentioning

confidence: 99%

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Median sternotomy versus intercostal thoracotomy for lung lobectomy: A comparison of short‐term outcome in 134 dogs

Bleakley

Phipps²,

Petrovsky³

et al. 2017

Veterinary Surgery

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Objective: To compare short-term outcomes between dogs undergoing lung lobectomy via median sternotomy (MS) or intercostal thoracotomy (ICT).Study design: Retrospective case control study.Methods: Medical records of dogs that underwent lung lobectomy via MS or ICT at a single institution were reviewed for demographics, intraoperative findings, and postoperative management and outcomes. Dogs with pleural effusion, pneumonia, migrating foreign body, lung abscess, spontaneous pneumothorax, or lung lobe torsion were excluded. Short-term outcome factors up were compared up to the time of death, euthanasia, or discharge from the hospital.Results: One hundred and thirty-four dogs met the inclusion criteria. Forty-one (31%) dogs underwent MS and 93 dogs (69%) underwent ICT. Fluid production from the chest tube (P 5 .0061), alveolar arterial pressure gradient (P 5 .0001), and complications requiring intervention (P 5 .0245) were more common in the MS group than the ICT group. Pain management and all other short-term outcome factors did not differ between procedures. Five dogs from the MS group and 4 from the ICT group were euthanized in the postoperative period (P 5 .0925). Conclusion:In a surgical procedure that does not preclude either approach, ICT may be more desirable than MS in terms of postoperative pain, oxygenation, and complications. However, since no other short-term measure of outcome differed, we can state that both MS and ICT are well tolerated by dogs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Median sternotomy versus intercostal thoracotomy for lung lobectomy: A comparison of short‐term outcome in 134 dogs

Bleakley

Phipps²,

Petrovsky³

et al. 2017

Veterinary Surgery

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“…Thoracostomy tubes have been associated with significant morbidity and complication rates ranging from 3%‐25% reported in the human medical literature . These rates are comparable to those reported in the recent veterinary literature (5%‐23%) . Thoracostomy tubes may be malpositioned when blindly placed (ie, the TT entering too far cranially, or insufficiently into the thorax).…”

Section: Introductionmentioning

confidence: 87%

“…[9][10][11] These rates are comparable to those reported in the recent veterinary literature (5%-23%). [12][13][14] Thoracostomy tubes may be malpositioned when blindly placed (ie, the TT entering too far cranially, or insufficiently into the thorax). Failure to evacuate the pleural space may result from obstruction of the tube with fibrinous debris or coiling or kinking of the tube.…”

Section: Introductionmentioning

confidence: 99%

Fluoroscopically guided wide‐bore thoracostomy tube placement: Description of the technique and comparison to blind placement

Barker¹,

Trinterud²,

Demetriou³

2018

Veterinary Surgery

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Objective To describe and compare fluoroscopic guidance for placement of wide‐bore thoracostomy tubes (FGTT) to traditional, blind placement of thoracostomy tubes (BPTT). Study design Prospective clinical trial. Animals Twenty client‐owned dogs. Methods Dogs requiring medical management of pleural effusion received a BPTT, whereas dogs undergoing postoperative management of pneumothorax and/or pleural fluid after lateral thoracotomy received an FGTT. Time of placement, accuracy of positioning, radiation exposure, and complications were compared between groups. Results Initial placement of BPTT took a mean of 168 seconds (range, 89‐197), whereas adequate placement was radiographically confirmed at 20 minutes and 38 seconds (range, 7 minutes and 57 seconds to 39 min). Initial placement of FGTT took a mean time of 108 seconds (range, 50‐341, P = .17), and adequate placement was confirmed at 125 seconds (range, 50‐341, P < .001). Major errors in placement requiring removal and replacement occurred in 2 dogs for BPTT and in none for FGTT. Procedural complications did not differ between groups, and no postoperative complication occurred within the first 12 hours after placement. Radiation entrance surface dose was lower in the BPTT group (P = .004), but stochastic radiation doses did not differ. Conclusion Fluoroscopic guidance of wide‐bore thoracostomy tubes accelerated the time to accurate tube placement and alleviated the requirement for removal and replacement in this population. Although use of fluoroscopy increased radiation entrance surface dose, the dose was not clinically significant. Clinical significance Fluoroscopic guidance of wide‐bore thoracostomy tubes should be considered as an alternative to traditional, blind placement.

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“…5 The current recommendation for closed suction drains is to remove them as early as possible, on the basis of evidence of decreasing fluid production and a plateau in fluid volume. Anecdotally, clinicians typically make subjective determinations about drainage, type of drain, and duration of drain placement on the basis of personal experience.…”

mentioning

confidence: 99%

Evaluation of fluid production and seroma formation after placement of closed suction drains in clean subcutaneous surgical wounds of dogs: 77 cases (2005–2012)

Shaver

Hunt

Kidd

2014

javma

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Retrospective analysis of the relationship between time of thoracostomy drain removal and discharge time

Cited by 19 publications

References 8 publications

Median sternotomy versus intercostal thoracotomy for lung lobectomy: A comparison of short‐term outcome in 134 dogs

Median sternotomy versus intercostal thoracotomy for lung lobectomy: A comparison of short‐term outcome in 134 dogs

Fluoroscopically guided wide‐bore thoracostomy tube placement: Description of the technique and comparison to blind placement

Evaluation of fluid production and seroma formation after placement of closed suction drains in clean subcutaneous surgical wounds of dogs: 77 cases (2005–2012)

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