Ambulatory Care With Digital Chest Drainage Safe, Effective for Prolonged Air Leak

Ambulatory treatment of prolonged air leak (PAL) with a digital monitoring device appears to have a high success rate with limited complications, according to a study published in the Journal of Thoracic Disease.

PAL, defined as a parenchymal air leak lasting more than 5 days, is a common complication of pneumothorax and occurs after 6% to 18% of lung resections. It is often associated with increased cost, a prolonged hospital stay, and other complications. Ambulatory treatment of PAL requires organization and monitoring, and previous studies regarding efficiency and safety show poor results.

For the current study, researchers reviewed retrospective data on the “Chance @ Home” program, which used the Thopaz^© digital chest drainage system (Medela Healthcare Inc.) in 140 patients with PAL over 10 years. The Chance @ Home program consisted of a team of specialized nurses consulted at hospital discharge, who visited patients at home on a daily basis for control of vital parameters, drain inspection, and dressing changes. Researchers studied the effectiveness and safety of the Thopaz ambulatory chest drainage system, a lightweight, compact device with integrated suction and a rechargeable battery that provides digital real-time data and a 24-hour trend of the air leak.

The investigators found that use of the digital monitoring device was successful in 112 patients (80.0%). However, hospital readmission was necessary in 33 patients (23.6%), and 28 (20.0%) of them received additional treatment, including video-assisted thoracoscopic surgery (n=19; 13.6%), new chest tube placement (n=8; 5.7%), and pleurodesis with talc slurry (n=1; 0.7%). Minor complications occurred in 10 patients (7.1%), and major complications requiring readmission occurred in 14 patients (10.0%).

“The ambulatory treatment program with specialized nurses monitoring a digital drainage system as described [in the study] resulted in a successful outpatient treatment of PAL in 80.0% of patients,” the study authors noted.

Reference

Dinjens L, de Boer WS, Stigt JA. Ambulant treatment with a digital chest tube for prolonged air leak is safe and effective. J Thorac Dis. 2021;13(12):6810-5. doi: 10.21037/jtd-21-1196