The purpose of this study is to determine whether chest tubes can be safely removed without considering how much fluid is draining through the tube.
Thoracostomy tubes are routinely used to drain the pleural space of fluid and gas to optimize pulmonary mechanics. Clinicians frequently postpone removal of thoracostomy tubes if the drainage from the tube exceeds a specific volume threshold for the prior 24 hours. However, there is substantial variability in the drainage volume threshold that different clinicians use, and no threshold has been established as clearly superior to any other. Removing tubes independently of the drainage volume may result in a greater risk of pleural effusion or pneumothorax requiring an invasive drainage procedure. However, removing tubes independently of the drainage volume might also expedite recovery by allowing earlier removal of the tube, thus diminishing pain and increasing patient mobility. Thoracostomy tube management practices, including the drainage volume threshold used, may be dissimilar for different types of disease processes, so this study will be restricted to patients who required a thoracostomy tube for treatment of traumatic injury.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
280
Removal of the thoracostomy tube independently of the amount of fluid that drained from the tube in the prior 24 hours
Removal of the thoracostomy tube only if the drainage from the tube in the prior 24 hours is less than 2 mL/kg of the patient's ideal body weight
University of California, Davis, Medical Center
Sacramento, California, United States
Invasive drainage procedure
Time frame: Within 60 days
Time to thoracostomy tube removal
Time frame: Within 60 days
Pulmonary symptoms
Time frame: 60 days
Mortality
Time frame: 60 days
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