Complications of Tube Thoracostomy- How Well Are We Training our junior Doctors?

Abstract

Objective:   This study aims to explore the common causative factors of dysfunctional closed chest drainage unit, their relative frequency and to give recommendations for its prevention.

Study Design:

Retrospective study

Place and Duration of study:

Department of Thoracic surgery, Nishter Medical University, Multan, between February 2015 and January 2017

Method:

139 patients were included in whom tube thoracostomy had been performed but it had failed in draining the pleural collection. Detailed history and thorough physical examination were carried out, Chest x-ray and where necessary chest CT scan were done to evaluate placement of chest tube and to work out the causative factor of dysfunctional closed chest drainage unit.

Results:

Out of the 139 study cases, 36(25.9%) were females while 103(74.1%) were male patients. Mean age of our study cases was 37.2 ±14.5 years (minimum age was 12 while maximum age was 65 years). A wrong connection of CDU was the most common cause of dysfunctional closed CDU. It was found in 24 cases (17.3%).Where as inadequate prime fluid, loose connections, kinked tubes; over full bottles were the other common problems.

Conclusion:

Dysfunctional closed chest drainage unit is a common but serious clinical problem which results in significant rise in morbidity, prolonged hospital stay and economic burden. It can be prevented by adopting proper protocol of tube thoracostomy.

Keywords: Dysfunctional chest drainage unit, Faulty chest tubes, Non-functioning tube thoracostomy, Failure of chest drainage system.

Abbreviations:

Chest drainage unit-CDU, tube thoracostomy-TT