Digital thoracic drainage: a new system to monitor air leaks in pediatric population

Abstract

Introduction: New digital thoracic drainage systems allow an objective measurement of air leakage. They have proven their usefulness in the postoperative thoracic surgery in adults, but there is little experience with its use in the pediatric population. The objective of our study is to analyze their safety and effectiveness in the postoperative period of the pediatric patients.

Method: A prospective consecutive observational study was done. All patients submitted to pulmonary resection between 2011 and 2017 and in whom digital thoracic drainage system was used (Thopaz Chest Drain System, Medela, Switzerland) were prospectively enrolled in this study. We analyzed variables: duration of chest tube (CT), days of hospitalization and radiographs in the immediate postoperative period related to the presence of CT. This group was compared with a historical cohort of patients (from 2011 to 2015) with a pulmonary resection in whom the traditional thoracic drainage was used. For the statistical analysis, the Mann-Whitney U-Test was used for independent samples.

Result: Twenty-six patients were included, Digital drainage system was used in13 patients and traditional drainage was used in 13 patients. The median age was 18 months (12 days-14 years). The mean number of days with the chest tube was 1.69 ± 0.6 in digital drainage group versus 5.38 ± 4 days in traditional drainage group (p < 0.05) The mean number of postoperative radiographs was 2.8 ± 1.1 in digital drainage group versus 6.23 ± 5.2 radiographs in traditional drainage group (p < 0.05). The average hospital stay in digital drainage group was 5.69 ± 2.7 days versus 7 ± 4.7 days in the traditional drainage group (p > 0.05). No complications related to the use of digital drainage group were registered.

Conclusion: The digital thoracic drainage systems provide an objective measurement of air leakage, allowing early chest tube removal and decreasing the number of radiographs performed postoperatively. Its use in the pediatric population appears to be safe and potentially beneficial.

Level of evidence: II.

Keywords: Chest tube removing; Children; Lung malformation; Thoracic drainage.