| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2001;71:1613-1617
© 2001 The Society of Thoracic Surgeons
a Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
b Division of Cardiothoracic Surgery, and Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
Accepted for publication January 17, 2001.
* Address reprint requests to Dr Cerfolio, Department of Surgery, Division of Cardiothoracic Surgery, University of Alabama at Birmingham, 1900 University Blvd, THT 712, Birmingham, AL 35294 (Email: robert.cerfolio{at}ccc.uab.edu).
Background. Surgeons treat air leaks differently. Our goal was to evaluate whether it is better to place chest tubes on suction or water seal for stopping air leaks after pulmonary surgery. A second goal was to evaluate a new classification system for air leaks that we developed.
Methods. Patients were prospectively randomized before surgery to receive suction or water seal to their chest tubes on postoperative day (POD) #2. Air leaks were described and quantified daily by a classification system and a leak meter. The air-leak meter scored leaks from 1 (least) to 7 (greatest). The group randomized to water seal stayed on water seal unless a pneumothorax developed.
Results. On POD #2, 33 of 140 patients had an air leak. Eighteen patients had been preoperatively randomized to water seal and 15 to suction. Air leaks resolved in 12 (67%) of the water seal patients by the morning of POD #3. All 6 patients whose air leak did not stop had a leak that was 4/7 or greater (p < 0.0001) on the leak meter. Of the 15 patients randomized to suction, only 1 patient’s air leak (7%) resolved by the morning of POD #3. The randomization aspect of the trial was ended and statistical analysis showed water seal was superior (p = 0.001). The remaining 14 patients were then placed to water seal and by the morning of POD #4, 13 patients’ leaks had stopped. Of the 32 total patients placed to seal, 7 (22%) developed a pneumothorax and 6 of these 7 patients had leaks that were 4/7 or greater (p = 0.001).
Conclusions. Placing chest tubes on water seal seems superior to wall suction for stopping air leaks after pulmonary resection. However, water seal does not stop expiratory leaks that are 4/7 or greater. Pneumothorax may occur when chest tubes are placed on seal with leaks this large.
This article has been cited by other articles:
|
|
 |
|
  A. Gonfiotti, P. F. Santini, M. Jaus, A. Janni, A. Lococo, A. R. De Massimi, A. D'Agostino, F. Carleo, M. Di Martino, V. Larocca, et al. Safety and Effectiveness of a New Fibrin Pleural Air Leak Sealant: A Multicenter, Controlled, Prospective, Parallel-Group, Randomized Clinical Trial Ann. Thorac. Surg., October 1, 2011; 92(4): 1217 - 1225. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Rivera, A. Bernard, P.-E. Falcoz, P. Thomas, A. Schmidt, S. Benard, E. Vicaut, and M. Dahan Characterization and Prediction of Prolonged Air Leak After Pulmonary Resection: A Nationwide Study Setting Up the Index of Prolonged Air Leak Ann. Thorac. Surg., September 1, 2011; 92(3): 1062 - 1068. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W. M. Bertholet, J. J. A. Joosten, M. E. Keemers-Gels, F. J. H. vanden Wildenberg, and W. B. Barendregt Chest tube management following pulmonary lobectomy: change of protocol results in fewer air leaks Interact CardioVasc Thorac Surg, January 1, 2011; 12(1): 28 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Allama Pleural tent for decreasing air leak following upper lobectomy: a prospective randomised trial Eur J Cardiothorac Surg, December 1, 2010; 38(6): 674 - 678. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. M. Marta, F. Facciolo, L. Ladegaard, H. Dienemann, A. Csekeo, F. Rea, S. Dango, L. Spaggiari, V. Tetens, and W. Klepetko Efficacy and safety of TachoSil(R) versus standard treatment of air leakage after pulmonary lobectomy, Eur J Cardiothorac Surg, December 1, 2010; 38(6): 683 - 689. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Deng, Q.-Y. Tan, Y.-P. Zhao, R.-W. Wang, and Y.-G. Jiang Suction or non-suction to the underwater seal drains following pulmonary operation: meta-analysis of randomised controlled trials Eur J Cardiothorac Surg, August 1, 2010; 38(2): 210 - 215. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, G. Varela, M. Refai, M. F. Jimenez, C. Pompili, A. Sabbatini, and J. L. Aranda A Scoring System to Predict the Risk of Prolonged Air Leak After Lobectomy Ann. Thorac. Surg., July 1, 2010; 90(1): 204 - 209. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Noppen Pneumothorax and bronchopleural fistula Respiratory Emergencies, June 28, 2010; 165 - 176. [Abstract] [Fulltext] [PDF]
|
|
|
|
|
|
 T. C. Mineo, E. Pompeo, H. B. Ris, W. Weder, P. Evrard, G. Massard, and N. Konietzko Surgery for emphysema: surgical aspects Surgery for Non-Neoplastic Disorders of the Chest: a Clinical Update, June 28, 2010; 113 - 128. [Abstract] [Fulltext] [PDF]
|
|
|
|
|
|
S. Singhal, V. A. Ferraris, C. R. Bridges, E. R. Clough, J. D. Mitchell, H. C. Fernando, and J. B. Shrager Management of Alveolar Air Leaks After Pulmonary Resection Ann. Thorac. Surg., April 1, 2010; 89(4): 1327 - 1335. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Ng, B. A. Ryder, J. T. Machan, and W. G. Cioffi Decreasing the incidence of prolonged air leak after right upper lobectomy with the anterior fissureless technique J. Thorac. Cardiovasc. Surg., April 1, 2010; 139(4): 1007 - 1011. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Liberman, A. Muzikansky, C. D. Wright, J. C. Wain, D. M. Donahue, J. S. Allan, H. A. Gaissert, C. R. Morse, D. J. Mathisen, and M. Lanuti Incidence and Risk Factors of Persistent Air Leak After Major Pulmonary Resection and Use of Chemical Pleurodesis Ann. Thorac. Surg., March 1, 2010; 89(3): 891 - 898. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, M. Salati, M. Refai, L. Di Nunzio, F. Xiume, and A. Sabbatini Evaluation of a new chest tube removal protocol using digital air leak monitoring after lobectomy: a prospective randomised trial Eur J Cardiothorac Surg, January 1, 2010; 37(1): 56 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Cerfolio, D. J. Minnich, and A. S. Bryant The Removal of Chest Tubes Despite an Air Leak or a Pneumothorax Ann. Thorac. Surg., June 1, 2009; 87(6): 1690 - 1696. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Sakakura, T. Fukui, S. Mori, S. Hatooka, K. Yokoi, and T. Mitsudomi Fluid Drainage and Air Evacuation Characteristics of Blake and Conventional Drains Used After Pulmonary Resection Ann. Thorac. Surg., May 1, 2009; 87(5): 1539 - 1545. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Tacconi, E. Pompeo, and T. C. Mineo Duration of air leak is reduced after awake nonresectional lung volume reduction surgery Eur J Cardiothorac Surg, May 1, 2009; 35(5): 822 - 828. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Vyas, I. Mitchell, J. Smart, D. Stoker, and A. K. Woolf Routine underwater seal drains are not required after transthoracic oesophagectomy: a pilot study Eur J Cardiothorac Surg, April 1, 2009; 35(4): 694 - 698. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Cerfolio and A. S. Bryant The quantification of postoperative air leaks MMCTS, January 1, 2009; 2009(0409): mmcts.2007.003129 - mmcts.2007.003129. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Mattioli, R. G. Berrisford, M. L. Lugaresi, and B. Aramini Survey on chest drainage systems adopted in Europe Interact CardioVasc Thorac Surg, December 1, 2008; 7(6): 1155 - 1159. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Cerfolio and A. S. Bryant The Benefits of Continuous and Digital Air Leak Assessment After Elective Pulmonary Resection: A Prospective Study Ann. Thorac. Surg., August 1, 2008; 86(2): 396 - 401. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Droghetti, A. Schiavini, P. Muriana, A. Folloni, M. Picarone, C. Bonadiman, C. Sturani, R. Paladini, and G. Muriana A prospective randomized trial comparing completion technique of fissures for lobectomy: stapler versus precision dissection and sealant. J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 383 - 391. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Cerfolio, A. S. Bryant, and L. M. Maniscalco Management of Subcutaneous Emphysema After Pulmonary Resection Ann. Thorac. Surg., May 1, 2008; 85(5): 1759 - 1765. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Cerfolio and A. S. Bryant Results of a prospective algorithm to remove chest tubes after pulmonary resection with high output. J. Thorac. Cardiovasc. Surg., February 1, 2008; 135(2): 269 - 273. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Rathinam and R. S. Steyn Management of complicated postoperative air-leak - a new indication for the Asherman chest seal Interact CardioVasc Thorac Surg, December 1, 2007; 6(6): 691 - 694. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Soberman Invited commentary Ann. Thorac. Surg., November 1, 2007; 84(5): 1661 - 1662. [Full Text] [PDF]
|
|
|
|
 |
|
 T. P Toma, O. M. Kon, W. Oldfield, R. Sanefuji, M. Griffiths, F. Wells, S. Sivasothy, M. Dusmet, D. M Geddes, and M. I Polkey Reduction of persistent air leak with endoscopic valve implants Thorax, September 1, 2007; 62(9): 830 - 833. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Andreetti, F. Venuta, M. Anile, T. De Giacomo, D. Diso, M. Di Stasio, E. A. Rendina, and G. F. Coloni Pleurodesis with an autologous blood patch to prevent persistent air leaks after lobectomy J. Thorac. Cardiovasc. Surg., March 1, 2007; 133(3): 759 - 762. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Dernevik, A. Belboul, and G. Radberg Initial experience with the world's first digital drainage system. The benefits of recording air leaks with graphic representation Eur J Cardiothorac Surg, February 1, 2007; 31(2): 209 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Singh, R. Agarwal, and D. Feller-Kopman Bronchopleural Fistula or Alveolopleural Fistula?: Not Just Semantics Chest, December 1, 2006; 130(6): 1948 - 1949. [Full Text] [PDF]
|
|
|
|
|
|
A. Droghetti, A. Schiavini, P. Muriana, A. Comel, G. De Donno, M. Beccaria, B. Canneto, C. Sturani, and G. Muriana Autologous blood patch in persistent air leaks after pulmonary resection. J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 556 - 559. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. H. Cho, A. Malhotra, D. M. Donahue, J. C. Wain, R. S. Harris, D. Karmpaliotis, and S. R. Patel Mechanical Ventilation and Air Leaks After Lung Biopsy for Acute Respiratory Distress Syndrome Ann. Thorac. Surg., July 1, 2006; 82(1): 261 - 266. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Tansley, F. Al-Mulhim, E. Lim, G. Ladas, and P. Goldstraw A prospective, randomized, controlled trial of the effectiveness of BioGlue in treating alveolar air leaks J. Thorac. Cardiovasc. Surg., July 1, 2006; 132(1): 105 - 112. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Sanni, A. Critchley, and J. Dunning Should chest drains be put on suction or not following pulmonary lobectomy? Interact CardioVasc Thorac Surg, June 1, 2006; 5(3): 275 - 278. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Anegg, J. Lindenmann, V. Matzi, D. Mujkic, A. Maier, L. Fritz, and F. M. Smolle-Juttner AIRFIX(R): the first digital postoperative chest tube airflowmetry--a novel method to quantify air leakage after lung resection Eur J Cardiothorac Surg, June 1, 2006; 29(6): 867 - 872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Ueda, Y. Kaneda, M. Sudo, J. Mitsutaka, T.-S. Li, K. Suga, N. Tanaka, and K. Hamano Quantitative Computed Tomography Versus Spirometry in Predicting Air Leak Duration After Major Lung Resection for Cancer Ann. Thorac. Surg., November 1, 2005; 80(5): 1853 - 1858. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, A. Sabbatini, F. Xiume', M. A. Refai, M. Salati, and R. Marasco Alternate Suction Reduces Prolonged Air Leak After Pulmonary Lobectomy: A Randomized Comparison Versus Water Seal Ann. Thorac. Surg., September 1, 2005; 80(3): 1052 - 1055. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. B. Marshall Invited commentary Ann. Thorac. Surg., September 1, 2005; 80(3): 1055 - 1055. [Full Text] [PDF]
|
|
|
|
|
|
R. J. Cerfolio, A. S. Bryant, S. Singh, C. S. Bass, and A. A. Bartolucci The Management of Chest Tubes in Patients With a Pneumothorax and an Air Leak After Pulmonary Resection Chest, August 1, 2005; 128(2): 816 - 820. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Manzanet, A. Vela, R. Corell, R. Moron, R. Calderon, and C. Suelves A Hydrodynamic Study of Pleural Drainage Systems: Some Practical Consequences Chest, June 1, 2005; 127(6): 2211 - 2221. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Okereke, S. C. Murthy, J. M. Alster, E. H. Blackstone, and T. W. Rice Characterization and Importance of Air Leak After Lobectomy Ann. Thorac. Surg., April 1, 2005; 79(4): 1167 - 1173. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Alphonso, C. Tan, M. Utley, R. Cameron, J. Dussek, L. Lang-Lazdunski, and T. Treasure A prospective randomized controlled trial of suction versus non-suction to the under-water seal drains following lung resection Eur J Cardiothorac Surg, March 1, 2005; 27(3): 391 - 394. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, M. Monteverde, A. Borri, M. Salati, R. D. Marasco, M. Al Refai, and A. Fianchini Comparison of water seal and suction after pulmonary lobectomy: a prospective, randomized trial Ann. Thorac. Surg., June 1, 2004; 77(6): 1932 - 1937. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Cerfolio Invited commentary Ann. Thorac. Surg., June 1, 2004; 77(6): 1937 - 1937. [Full Text] [PDF]
|
|
|
|
|
|
A. Watanabe, T. Watanabe, H. Ohsawa, T. Mawatari, Y. Ichimiya, N. Takahashi, H. Sato, and T. Abe Avoiding chest tube placement after video-assisted thoracoscopic wedge resection of the lung Eur J Cardiothorac Surg, May 1, 2004; 25(5): 872 - 876. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, M. Monteverde, A. Borri, M. Salati, R. D. Marasco, and A. Fianchini Predictors of prolonged air leak after pulmonary lobectomy Ann. Thorac. Surg., April 1, 2004; 77(4): 1205 - 1210. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Czerny, T. Fleck, A. Salat, D. Zimpfer, W. Klepetko, E. Wolner, and M. R. Mueller Sealing of the mediastinum with a local hemostyptic agent reduces chest tube duration after complete mediastinal lymph node dissection for stage I and II non-small cell lung carcinoma Ann. Thorac. Surg., March 1, 2004; 77(3): 1028 - 1032. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Ueda, Y. Kaneda, H. Sakano, T. Tanaka, T.-S. Li, and K. Hamano Obstacles for shortening hospitalization after video-assisted pulmonary resection for lung cancer Ann. Thorac. Surg., December 1, 2003; 76(6): 1816 - 1820. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Martin-Ucar, E. Passera, R. Vaughan, and G. Rocco Implementation of a user-friendly protocol for interpretation of air-leaks and management of intercostal chest drains after thoracic surgery Interact CardioVasc Thorac Surg, September 1, 2003; 2(3): 251 - 255. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Carroll What circumstances warrant a chest drain suction pressure greater than -20 cm H2O? Crit. Care Nurse, August 1, 2003; 23(4): 73 - 74. [Full Text] [PDF]
|
|
|
|
|
|
T. Fabian, J. A. Federico, and R. B. Ponn Fibrin glue in pulmonary resection: a prospective, randomized, blinded study Ann. Thorac. Surg., May 1, 2003; 75(5): 1587 - 1592. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. K. Ayed Suction versus water seal after thoracoscopy for primary spontaneous pneumothorax: prospective randomized study Ann. Thorac. Surg., May 1, 2003; 75(5): 1593 - 1596. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Cerfolio, C. S. Bass, A. H. Pask, and C. R. Katholi Predictors and treatment of persistent air leaks Ann. Thorac. Surg., June 1, 2002; 73(6): 1727 - 1731. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. B. Marshall, M. E. Deeb, J. I. S. Bleier, J. C. Kucharczuk, J. S. Friedberg, L. R. Kaiser, and J. B. Shrager Suction vs Water Seal After Pulmonary Resection : A Randomized Prospective Study Chest, March 1, 2002; 121(3): 831 - 835. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
