scholarly journals Routine chest X-rays after pigtail chest tube removal rarely change management in children

2021 ◽  
Author(s):  
Christina M. Theodorou ◽  
Mennatalla S. Hegazi ◽  
Hope Nicole Moore ◽  
Alana L. Beres
Keyword(s):  
Pleural Effusion ◽  
Change Management ◽  
Chest Tube ◽  
Primary Outcome ◽  
X Rays ◽  
Chest Tubes ◽  
Exclusion Criteria ◽  
Tube Removal ◽  
Chest Tube Removal ◽  
Routine Chest

Abstract Background The need for chest X-rays (CXR) following large-bore chest tube removal has been questioned; however, the utility of CXRs following removal of small-bore pigtail chest tubes is unknown. We hypothesized that CXRs obtained following removal of pigtail chest tubes would not change management. Methods Patients < 18 years old with pigtail chest tubes placed 2014–2019 at a tertiary children’s hospital were reviewed. Exclusion criteria were age < 1 month, death or transfer with a chest tube in place, or pigtail chest tube replacement by large-bore chest tube. The primary outcome was chest tube reinsertion. Results 111 patients underwent 123 pigtail chest tube insertions; 12 patients had bilateral chest tubes. The median age was 5.8 years old. Indications were pneumothorax (n = 53), pleural effusion (n = 54), chylothorax (n = 6), empyema (n = 5), and hemothorax (n = 3). Post-pull CXRs were obtained in 121/123 cases (98.4%). The two children without post-pull CXRs did not require chest tube reinsertion. Two patients required chest tube reinsertion (1.6%), both for re-accumulation of their chylothorax. Conclusions Post-pull chest X-rays are done nearly universally following pigtail chest tube removal but rarely change management. Providers should obtain post-pull imaging based on symptoms and underlying diagnosis, with higher suspicion for recurrence in children with chylothorax.

Chest tube removal after cardiac surgery

1997 ◽  
Vol 17 (1) ◽  
pp. 34-38 ◽  
Author(s):  
SC Thomson ◽  
S Wells ◽  
M Maxwell
Keyword(s):  
Cardiac Surgery ◽  
Quality Of Care ◽  
Length Of Stay ◽  
Chest Tube ◽  
Chest Tubes ◽  
Tube Removal ◽  
Chest Tube Removal

Prompt remove of chest tubes by RNs has allowed earlier and more aggressive ambulation of our patients and, along with other interventions, has decreased length of stay by 1.5 days while improving quality of care. Proper education, both didactic and clinical, is the key component in preparing RNs to safely and effectively perform this procedure.

scholarly journals Implementation and Effectiveness of Early Chest Tube Removal during an Enhanced Recovery Programme after Oesophago-gastrectomy

2015 ◽  
Vol 53 (197) ◽  
pp. 24-27 ◽  
Author(s):  
Rajeev Bhandari ◽  
You Yong-hao
Keyword(s):  
Pleural Effusion ◽  
Hospital Stay ◽  
Chest Tube ◽  
Enhanced Recovery ◽  
Task Force ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Tube Removal ◽  
Significant Difference ◽  
Chest Tube Removal

Introduction: Oesophageal resection were notoriously complicated and produces a cohort of patients prone to postoperative complications and here we would like to focus on the implementation and effectiveness of early chest tube removal in ERAS after oesophago-gastrectomy considering the various aspect like pleural effusion and reducing the length of hospital stay which ultimately lead to reducing the economic burden on patient.Methods: An ERAS programme was devised and implemented with the support of a dedicated in-hospital task-force. The patients underwent esophago-gastrectomy were randomly divided into two groups: the ERAS group and the control group (non-ERAS). The ERAS group was treated with early removal of the chest tube after surgery, and the control group was treated with traditional way and outcomes were compared between them.Results: The length of hospital stay and the cost of hospitalization in the ERAS group were significantly lower than those in the control group（p<0.05. However, there was no statistical significant difference in the incidences of pleural effusion between the two groups（p＞0.05).Conclusions: The introduction of early chest tube removal as an ERAS programme after oesophago-gastrectomy would not increase the risk of pleural effusion and would not increase the total length of stay and cost of hospitalisation without jeopardising patient safety or clinical outcomes.

Omission of routine chest x-ray after chest tube removal is safe in selected trauma patients

2010 ◽  
Vol 199 (2) ◽  
pp. 199-203 ◽  
Author(s):  
Michael D. Goodman ◽  
Nathan L. Huber ◽  
Jay A. Johannigman ◽  
Timothy A. Pritts
Keyword(s):  
Chest Tube ◽  
Trauma Patients ◽  
X Ray ◽  
Tube Removal ◽  
Chest X Ray ◽  
Chest Tube Removal ◽  
Routine Chest

Efficacy of Routine Chest X-ray after Chest Tube Removal in Patients Undergoing Cardiac Surgeries

2007 ◽  
Vol 7 (4) ◽  
pp. 686-689 ◽  
Author(s):  
Mohammad Hussein Mandegar ◽  
Masih Shafa . ◽  
Mohammad Ghazinoor .
Keyword(s):  
Chest Tube ◽  
X Ray ◽  
Tube Removal ◽  
Chest X Ray ◽  
Chest Tube Removal ◽  
Routine Chest

Is routine chest radiograph necessary after chest tube removal?

2014 ◽  
Vol 49 (10) ◽  
pp. 1493-1495 ◽  
Author(s):  
Janine P. Cunningham ◽  
E. Marty Knott ◽  
Alessandra C. Gasior ◽  
David Juang ◽  
Charles L. Snyder ◽  
...  
Keyword(s):  
Chest Radiograph ◽  
Chest Tube ◽  
Tube Removal ◽  
Chest Tube Removal ◽  
Routine Chest

The efficacy of x-rays after chest tube removal

2000 ◽  
Vol 179 (1) ◽  
pp. 15
Author(s):  
Scott R Peterson ◽  
Rudy Lackner ◽  
Steven Parks
Keyword(s):  
Chest Tube ◽  
X Rays ◽  
Tube Removal ◽  
Chest Tube Removal

The efficacy of x-rays after chest tube removal

2000 ◽  
Vol 179 (1) ◽  
pp. 13-15 ◽  
Author(s):  
J.Alexander Palesty ◽  
Alicia A McKelvey ◽  
Stanley J Dudrick
Keyword(s):  
Chest Tube ◽  
X Rays ◽  
Tube Removal ◽  
Chest Tube Removal

Pain Levels Experienced With Activities After Cardiac Surgery

2004 ◽  
Vol 13 (2) ◽  
pp. 116-125 ◽  
Author(s):  
Lesley B. Milgrom ◽  
Jo Ann Brooks ◽  
Rong Qi ◽  
Karen Bunnell ◽  
Susie Wuestefeld ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Chest Tube ◽  
Activity Levels ◽  
Deep Breathing ◽  
Chest Tubes ◽  
Pain Scores ◽  
Tube Removal ◽  
Before And After ◽  
Lower Pain ◽  
Chest Tube Removal

• Background Acute pain is common after cardiac surgery and can keep patients from participating in activities that prevent postoperative complications. Accurate assessment and understanding of pain are vital for providing satisfactory pain control and optimizing recovery.• Objectives To describe pain levels for 5 activities expected of patients after cardiac surgery on postoperative days 1 to 6 and changes in pain levels after chest tube removal and extubation.• Methods Adults who underwent cardiac surgery were asked to rate the pain associated with various types of activities on postoperative days 1 to 6. Pain levels were compared by postoperative day, activity, and type of cardiac surgery. Pain scores before and after chest tube removal and extubation also were analyzed.• Results Pain scores were higher on earlier postoperative days. The order of overall pain scores among activities (P &lt; .01) from highest to lowest was coughing, moving or turning in bed, getting up, deep breathing or using the incentive spirometer, and resting. Changes in pain reported with coughing (P=.03) and deep breathing or using the incentive spirometer (P = .005) differed significantly over time between surgery groups. After chest tubes were discontinued, patients had lower pain levels at rest (P = .01), with coughing (P=.05), and when getting up (P=.03).• Conclusions Pain relief is an important outcome of care. A comprehensive, individualized assessment of pain that incorporates activity levels is necessary to promote satisfactory management of pain.

Comparison of pain and efficacy between large-bore and small-bore chest tube drainage for malignant pleural effusion in Songklanagarind Hospital: A randomized controlled trial.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19608-e19608
Author(s):  
Apirudee Porntepkasemson ◽  
Sarayut Lucien Geater
Keyword(s):  
Randomized Controlled Trial ◽  
Pleural Effusion ◽  
Chest Tube ◽  
Malignant Pleural Effusion ◽  
Controlled Trial ◽  
Chest Tubes ◽  
Tube Insertion ◽  
Randomized Controlled ◽  
Lung Expansion ◽  
Tube Removal

e19608 Background: Malignant pleural effusion is one of the most common presenting symptoms in lung cancer. There has been no large RCT comparing large-bore and small-bore chest tubes in terms of pain and efficacy of management. Methods: A randomized controlled trial was conducted in 2011. Patients with malignant pleural effusion were randomly allocated to receive either a large-bore or small-bore chest tube. The primary objective was to compare pain using the Numeric Rating Scale. Other objectives included the efficacy of the drainage and pleurodesis and any complications were recorded. Results: Each arm comprised 21 patients. Median age was 61.2 years. Thirty-eight patients (90.5%) had adenocarcinoma; 14(33.3%) had received systemic chemotherapy. Pain score did not differ significantly between the groups from the time of tube insertion to removal. However, pain rose from day 4 until day 9 in the small-bore group. The proportion of patients requiring a second chest tube was higher in the small-bore group (small-bore = 7, 33.3 %; large-bore = 1, 4.8%; p 0.052). Complications were higher in the small-bore group. Five patients were complicated by tube occlusion which occurred only in the small-bore group (23.8 %, p 0.048). Times from tube insertion to lung expansion, to pleurodesis and to chest tube removal did not differ significantly between groups. Pleurodesis was effective in 70-80 % in both groups at the 28-day follow-up. Conclusions: No differences between large-bore and small-bore chest tubes were seen in pain, efficacy of drainage or success of pleurodesis. However, small-bore chest tubes had a higher rate of occlusion and more frequently required additional tube insertion.

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