Effects of Local Protocols on Duration of Chest Tube Therapy Following Thoracic Surgery

The management of chest tubes is probably one of the most critical aspects in patient care in thoracic surgery and defines the required length of postoperative hospital stay in the majority of patients. So far, no generally accepted recommendations exist for postoperative chest tube management to streamline the postoperative stay. Instead, decision making in most thoracic surgery units is based on team preferences and individual training rather than scientific data. Therefore, digital pleural drainage systems represent a useful tool to standardize existing intradepartmental protocols for chest tube management. However, for the development of generally accepted protocol-recommendations, the diverging interdepartmental treatment protocols have to be analyzed and compared for superiority. In this IIT, the effect of different chest tube management protocols on chest tube duration is analyzed in four German Thoracic Surgery units.

• Chest tube removal (Procedure): Chest tube removal on the basis of local recommendations for postoperative chest tube management

Primary outcomes

• chest tube therapy duration [participants are followed for the duration of hospital stay, an expected average of 5 days]: number of days following thoracic surgery until chest tube was removed

Secondary outcomes

• presence of pulmonary air leak [participants are followed for the duration of hospital stay, an expected average of 4 days]: number of days the Medela Thopaz device detected a pulmonary air leak following thoracic surgery

Sex: All, ages: 18 Years to 85 Years

Inclusion Criteria:

* age 18-85
* following pulmonary wedge resection, anatomic segmentectomy, or lobectomy

Exclusion Criteria:

* surgery for spontaneous pneumothorax (primary and secondary)
* surgery for pleural empyema
* present medication with corticoids, immunosuppressive drugs or platelet aggregation inhibitors other than Aspirin
* history of chemotherapy, radiotherapy of the chest, or previous ipsilateral thoracic surgery

• Results publication: Linder A, Ertner C, Steger V, Messerschmidt A, Merk J, Cregan I, Timm J, Walles T. Postoperative chest tube management: snapshot of German diversity. Interact Cardiovasc Thorac Surg. 2012 Oct;15(4):622-6. doi: 10.1093/icvts/ivs270. Epub 2012 Jun 29. PMID 22753431

• Albert Linder, MD, Study director, Klinikum Bremen-Ost gGmbH
• Thorsten Walles, MD, Principal investigator, Schillerhoehe Hospital
• Josef Wolf, Study chair, Medela GmbH & Co. Handels KG