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How to distinguish an active air leak from a pleural space effect.
MedLine Citation:
PMID:  23284110     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Aim: We aimed to distinguish a pleural space effect from an active air leak, using a digital chest drain system that provided continuous air flow and pleural pressure checks. Methods: between March 2010 and October 2011, we employed 144 digital drains for 138 thoracic surgical procedures. Results: We observed 18 (12.5%) active air leaks, among which 4 (2.8%) were prolonged air leaks characterized by high differential pleural pressure due to increased mean expiratory pressure (>1 cm H(2)O; p<0.0001), and 3 (2.1%) late air leaks, all long-lasting (p<0.0001), predicted by pressure curve divergence before the air flow appearance. We also reported 25 (17.4%) pleural space effects characterized by a high differential pleural pressure, but mainly due to a lower mean inspiratory pressure (<20 cm H(2)O; p<0.0001), and especially related to surgical pleurodesis procedures (p<0.0003) and wide lung resections (p<0.0002); there was no increasing pneumothorax after provocative clamping. Conclusions: A digital chest drain system, ensuring continuous air flow and pleural pressure measurement, could clearly identify a pleural space effect, avoiding the frequent misinterpretation of an active air leak, and allowing safe removal of the chest tube at the right time.
Authors:
Rita Daniela Marasco; Gabriella Giudice; Cosimo Lequaglie
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Asian cardiovascular & thoracic annals     Volume:  20     ISSN:  1816-5370     ISO Abbreviation:  Asian Cardiovasc Thorac Ann     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2013-01-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503417     Medline TA:  Asian Cardiovasc Thorac Ann     Country:  England    
Other Details:
Languages:  eng     Pagination:  682-8     Citation Subset:  IM    
Affiliation:
d.marasco@inwind.it.
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