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Semin Respir Crit Care Med 2019; 40(03): 386-393
DOI: 10.1055/s-0039-1694769
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Chest Tube Drainage Devices

Jennifer W. Toth
1   Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
,
Michael F. Reed
2   Division of Thoracic Surgery, Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
,
Lauren K. Ventola
1   Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
› Author Affiliations
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Publication History

Publication Date:
16 September 2019 (online)

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Abstract

Placement of a chest tube drains intrapleural fluid and air. The tube should be attached to a drainage system, such as one-, two-, or three-compartment devices, a one-way (Heimlich) valve for ambulatory drainage, a digital system, or a vacuum bottle. The frequently employed three-compartment systems, currently integrated disposable units, allow adjustment of negative pressure or no suction (water seal), and include an air leak meter on the water seal chamber to be used for demonstrating and quantifying air leak. These readings are subjective and prone to interobserver variability. Digital pleural drainage systems offer the benefits of quantification of any air leak and pleural pressure. Indwelling pleural catheters, typically utilized for malignant pleural effusion, can be drained using vacuum bottles. Knowledge of the design and functionality of each device in the setting of an individual patient's specific pleural process facilitates the selection of practical and financially prudent chest tube drainage strategies.

Keywords

chest tube - pleural drainage system - digital drainage systems - tube thoracostomy - pleural catheters - air leak - pleural effusion
 

  • References

  • 1 Munnell ER. Thoracic drainage. Ann Thorac Surg 1997; 63 (05) 1497-1502
    CrossrefPubMedSearch in Google Scholar
  • 2 Playfair GE. Case of empyema treated by aspiration and subsequently by drainage: recovery. BMJ 1875; 1: 45
    CrossrefPubMedSearch in Google Scholar
  • 3 Zisis C, Tsirgogianni K, Lazaridis G. , et al. Chest drainage systems in use. Ann Transl Med 2015; 3 (03) 43
    PubMedSearch in Google Scholar
  • 4 Porcel JM. Chest tube drainage of the pleural space: a concise review for pulmonologists. Tuberc Respir Dis (Seoul) 2018; 81 (02) 106-115
    CrossrefPubMedSearch in Google Scholar
  • 5 Cerfolio RJ, Bass C, Katholi CR. Prospective randomized trial compares suction versus water seal for air leaks. Ann Thorac Surg 2001; 71 (05) 1613-1617
    CrossrefPubMedSearch in Google Scholar
  • 6 Cerfolio RJ. Advances in thoracostomy tube management. Surg Clin North Am 2002; 82 (04) 833-848 , vii
    CrossrefPubMedSearch in Google Scholar
  • 7 Alphonso N, Tan C, Utley M. , et al. A prospective randomized controlled trial of suction versus non-suction to the under-water seal drains following lung resection. Eur J Cardiothorac Surg 2005; 27 (03) 391-394
    CrossrefPubMedSearch in Google Scholar
  • 8 Okamoto J, Okamoto T, Fukuyama Y, Ushijima C, Yamaguchi M, Ichinose Y. The use of a water seal to manage air leaks after a pulmonary lobectomy: a retrospective study. Ann Thorac Cardiovasc Surg 2006; 12 (04) 242-244
    PubMedSearch in Google Scholar
  • 9 Rocco G, Brunelli A, Rocco R. Suction or nonsuction: how to manage a chest tube after pulmonary resection. Thorac Surg Clin 2017; 27 (01) 35-40
    CrossrefPubMedSearch in Google Scholar
  • 10 Zhou J, Chen N, Hai Y. , et al. External suction versus simple water-seal on chest drainage following pulmonary surgery: an updated meta-analysis. Interact Cardiovasc Thorac Surg 2019; 28 (01) 29-36
    CrossrefPubMedSearch in Google Scholar
  • 11 Heimlich HJ. Valve drainage of the pleural cavity. Dis Chest 1968; 53 (03) 282-287
    CrossrefPubMedSearch in Google Scholar
  • 12 Cerfolio RJ, Bryant AS. The benefits of continuous and digital air leak assessment after elective pulmonary resection: a prospective study. Ann Thorac Surg 2008; 86 (02) 396-401
    CrossrefPubMedSearch in Google Scholar
  • 13 Gogakos A, Barbetakis N, Lazaridis G. , et al. Heimlich valve and pneumothorax. Ann Transl Med 2015; 3 (04) 54
    PubMedSearch in Google Scholar
  • 14 McKenna Jr RJ, Fischel RJ, Brenner M, Gelb AF. Use of the Heimlich valve to shorten hospital stay after lung reduction surgery for emphysema. Ann Thorac Surg 1996; 61 (04) 1115-1117
    CrossrefPubMedSearch in Google Scholar
  • 15 Cerfolio RJ, Bass CS, Pask AH, Katholi CR. Predictors and treatment of persistent air leaks. Ann Thorac Surg 2002; 73 (06) 1727-1730 , discussion 1730–1731
    CrossrefPubMedSearch in Google Scholar
  • 16 Anegg U, Lindenmann J, Matzi V. , et al. AIRFIX: the first digital postoperative chest tube airflowmetry--a novel method to quantify air leakage after lung resection. Eur J Cardiothorac Surg 2006; 29 (06) 867-872
    CrossrefPubMedSearch in Google Scholar
  • 17 Varela G, Jiménez MF, Novoa NM, Aranda JL. Postoperative chest tube management: measuring air leak using an electronic device decreases variability in the clinical practice. Eur J Cardiothorac Surg 2009; 35 (01) 28-31
    CrossrefPubMedSearch in Google Scholar
  • 18 Brunelli A, Salati M, Refai M, Di Nunzio L, Xiumé F, Sabbatini A. Evaluation of a new chest tube removal protocol using digital air leak monitoring after lobectomy: a prospective randomised trial. Eur J Cardiothorac Surg 2010; 37 (01) 56-60
    CrossrefPubMedSearch in Google Scholar
  • 19 Cerfolio RJ, Varela G, Brunelli A. Digital and smart chest drainage systems to monitor air leaks: the birth of a new era?. Thorac Surg Clin 2010; 20 (03) 413-420
    CrossrefPubMedSearch in Google Scholar
  • 20 De Waele M, Agzarian J, Hanna WC. , et al. Does the usage of digital chest drainage systems reduce pleural inflammation and volume of pleural effusion following oncologic pulmonary resection?-A prospective randomized trial. J Thorac Dis 2017; 9 (06) 1598-1606
    CrossrefPubMedSearch in Google Scholar
  • 21 Cerfolio RJ, Pickens A, Bass C, Katholi C. Fast-tracking pulmonary resections. J Thorac Cardiovasc Surg 2001; 122 (02) 318-324
    CrossrefPubMedSearch in Google Scholar