| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2002;73:1727-1731
© 2002 The Society of Thoracic Surgeons
a Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
* Address reprint requests to Dr Cerfolio, Division of Cardiothoracic Surgery, University of Alabama at Birmingham, 1900 University Blvd, THT 712, Birmingham, AL 35294, USA
e-mail: Robert.cerfolio{at}ccc.uab.edu
Presented at the Forty-eighth Annual Meeting of the Southern Thoracic Surgical Association, San Antonio, TX, Nov 8–10, 2001.
Background. Air leaks prolong hospital stay.
Methods. A prospective algorithm was applied to patients. If patients were ready for discharge but still had an air leak, a Heimlich valve was placed and they were discharged. If the leak was still present after 2 weeks, the tube was clamped for a day and removed.
Results. There were 669 patients. Factors that predicted a persistent air leak were FEV1% of less than 79% (p = 0.006), history of steroid use (p = 0.002), male gender (p = 0.05), and having a lobectomy (p = 0.01). Types of air leaks on day 1 that eventually required a Heimlich valve were expiratory leaks (p = 0.02), leaks that were an expiratory 4 or more (p < 0.0001), and the presence of a pneumothorax concomitant with an air leak (p < 0.0001). Thirty-three patients were placed on a Heimlich valve, and 6 patients had a pneumothorax or subcutaneous emphysema develop; all patients had an expiratory 5 leak or larger (p < 0.0001). Thirty-three patients went home on a valve. Seventeen patients had leaks that resolved by 1 week, 6 by 2 weeks, and the remaining 9 had their tubes removed without problems.
Conclusions. Steroid use, male gender, a large leak, a leak with a pneumothorax, and having a lobectomy are all risk factors for a persistent leak. Discharge on a Heimlich valve is safe and effective for patients with a persistent leak unless the leak is an expiratory 5 or more. Once home on a valve, most air leaks will seal in 2 weeks; if not, chest tubes can be safely removed regardless of the size of the leak or the presence of a pneumothorax.
This article has been cited by other articles:
|
|
 |
|
  J. M. Travaline, R. J. McKenna Jr, T. De Giacomo, F. Venuta, S. R. Hazelrigg, M. Boomer, G. J. Criner, and for the Endobronchial Valve for Persistent Air Lea Treatment of Persistent Pulmonary Air Leaks Using Endobronchial Valves Chest, August 1, 2009; 136(2): 355 - 360. [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]
|
|
|
|
 |
|
 S. Mattioli, R. G. Berrisford, M. L. Lugaresi, and B. Aramini Survey on chest drainage systems adopted in Europe Interactive CardioVascular and Thoracic Surgery, December 1, 2008; 7(6): 1155 - 1159. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Moser, I. Opitz, W. Zhai, V. Rousson, E.W. Russi, W. Weder, and D. Lardinois Autologous fibrin sealant reduces the incidence of prolonged air leak and duration of chest tube drainage after lung volume reduction surgery: a prospective randomized blinded study. J. Thorac. Cardiovasc. Surg., October 1, 2008; 136(4): 843 - 849. [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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
B. A. Whitson, R. S. Andrade, A. Boettcher, R. Bardales, R. A. Kratzke, P. S. Dahlberg, and M. A. Maddaus Video-Assisted Thoracoscopic Surgery is More Favorable Than Thoracotomy for Resection of Clinical Stage I Non-Small Cell Lung Cancer Ann. Thorac. Surg., June 1, 2007; 83(6): 1965 - 1970. [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]
|
|
|
|
 |
|
 U. Anegg, J. Lindenmann, V. Matzi, J. Smolle, A. Maier, and F. Smolle-Juttner Efficiency of fleece-bound sealing (TachoSil(R)) of air leaks in lung surgery: a prospective randomised trial Eur. J. Cardiothorac. Surg., February 1, 2007; 31(2): 198 - 202. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Gomez-Caro, M. J. R. Calvo, J. T. Lanzas, R. Chau, P. Cascales, and P. Parrilla The approach of fused fissures with fissureless technique decreases the incidence of persistent air leak after lobectomy Eur. J. Cardiothorac. Surg., February 1, 2007; 31(2): 203 - 208. [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]
|
|
|
|
|
|
A. Brunelli, F. Xiume, M. Al Refai, M. Salati, R. Marasco, and A. Sabbatini Air leaks after lobectomy increase the risk of empyema but not of cardiopulmonary complications: a case-matched analysis. Chest, October 1, 2006; 130(4): 1150 - 1156. [Abstract] [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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
P. A. Linden, R. Bueno, Y. L. Colson, M. T. Jaklitsch, J. Lukanich, S. Mentzer, and D. J. Sugarbaker Lung Resection in Patients With Preoperative FEV1 < 35% Predicted Chest, June 1, 2005; 127(6): 1984 - 1990. [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]
|
|
|
|
|
|
A. K. Konstantakos A Simple and Effective Method of Preventing Inadvertent Occlusion of Chest Tube Drains: The Corrugated Tubing Splint Ann. Thorac. Surg., March 1, 2005; 79(3): 1070 - 1071. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Varela, M. F. Jimenez, N. Novoa, and J. L. Aranda Estimating hospital costs attributable to prolonged air leak in pulmonary lobectomy Eur. J. Cardiothorac. Surg., February 1, 2005; 27(2): 329 - 333. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Stolz, J. Schutzner, R. Lischke, J. Simonek, and P. Pafko Predictors of prolonged air leak following pulmonary lobectomy Eur. J. Cardiothorac. Surg., February 1, 2005; 27(2): 334 - 336. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Allen, D. E. Wood, R. W. Hawkinson, D. H. Harpole, R. J. McKenna, G. L. Walsh, E. Vallieres, D. L. Miller, F. C. Nichols III, W. R. Smythe, et al. Prospective randomized study evaluating a biodegradable polymeric sealant for sealing intraoperative air leaks that occur during pulmonary resection Ann. Thorac. Surg., May 1, 2004; 77(5): 1792 - 1801. [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]
|
|
|
|
|
|
C. A. Keller Lasers, Staples, Bovine Pericardium, Talc, Glue and... Suction Cylinders?: Tools of the Trade To Avoid Air Leaks in Lung Volume Reduction Surgery Chest, February 1, 2004; 125(2): 361 - 363. [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 Interactive CardioVascular and Thoracic Surgery, September 1, 2003; 2(3): 251 - 255. [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 |
