Clamping trials prior to thoracostomy tube removal and the need for subsequent invasive pleural drainage

James C. Becker, Scott A. Zakaluzny, Benjamin A. Keller, Joseph M. Galante, Garth H. Utter

Research output: Contribution to journalArticle

Abstract

Background: There is little evidence supporting or refuting clamping trials, a period of clamping thoracostomy tubes prior to removal. We sought to evaluate whether clamping trials reduce the need for subsequent pleural drainage procedures. Methods: We conducted a retrospective cohort study of trauma patients who underwent tube thoracostomy during 2009–2015. We compared patients who underwent clamping trials to those who did not, adjusting for confounders. The primary outcome was subsequent ipsilateral pleural drainage within 30 days. Results: We evaluated 214 clamping trial and 285 control patients. Only two of 214 patients failed their clamping trial and none developed a tension pneumothorax [0.0% (95% CI 0.0–1.7%)]. Clamping trials were associated with fewer pleural drainage procedures [13 (6%) vs. 33 (12%); adjusted OR 0.41 (95% CI 0.20–0.84)]. Conclusions: A clamping trial prior to thoracostomy tube removal seems to be safe and was associated with less likelihood of a subsequent pleural drainage procedure.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - Jan 1 2020

Fingerprint

Thoracostomy
Constriction
Drainage
Pneumothorax
Cohort Studies
Retrospective Studies

Keywords

  • Chest tube
  • Clamping trial
  • Pneumothorax
  • Thoracostomy tube

ASJC Scopus subject areas

  • Surgery

Cite this

Clamping trials prior to thoracostomy tube removal and the need for subsequent invasive pleural drainage. / Becker, James C.; Zakaluzny, Scott A.; Keller, Benjamin A.; Galante, Joseph M.; Utter, Garth H.

In: American Journal of Surgery, 01.01.2020.

Research output: Contribution to journalArticle

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abstract = "Background: There is little evidence supporting or refuting clamping trials, a period of clamping thoracostomy tubes prior to removal. We sought to evaluate whether clamping trials reduce the need for subsequent pleural drainage procedures. Methods: We conducted a retrospective cohort study of trauma patients who underwent tube thoracostomy during 2009–2015. We compared patients who underwent clamping trials to those who did not, adjusting for confounders. The primary outcome was subsequent ipsilateral pleural drainage within 30 days. Results: We evaluated 214 clamping trial and 285 control patients. Only two of 214 patients failed their clamping trial and none developed a tension pneumothorax [0.0{\%} (95{\%} CI 0.0–1.7{\%})]. Clamping trials were associated with fewer pleural drainage procedures [13 (6{\%}) vs. 33 (12{\%}); adjusted OR 0.41 (95{\%} CI 0.20–0.84)]. Conclusions: A clamping trial prior to thoracostomy tube removal seems to be safe and was associated with less likelihood of a subsequent pleural drainage procedure.",
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AU - Keller, Benjamin A.

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AU - Utter, Garth H.

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KW - Clamping trial

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