None listed
Conditions
Brief summary
The purpose is to investigate whether one method of removing a chest drain is better than another with at reducing complications such as pneumothorax (“collapsed lung”) which can occur when a chest drain is removed. Chest drains are commonly removed in one of two ways – either after the patient has taken a deep breath in, or whilst the patient is blowing out. Pneumothorax is a known complication following removal of chest drains, but it is not clear which of these two methods of chest drain removal results in a lower incidence of pneumothorax.
Interventions
Patients who have had chest drains inserted for various indications including thoracic surgery, spontaneous pneumothoraces or following drainage of pleural effusions and who are ready to undergo drain removal will be included in the study. The drain will be removed during a Valsalva manoeuvre, performed in forced expiration against a closed airway (by instructing the patient to put their thumb in their mouth and blow as if blowing a whistle). The procedure takes approximately 5 seconds and is a
Patients who have had chest drains inserted for various indications including thoracic surgery, spontaneous pneumothoraces or following drainage of pleural effusions and who are ready to undergo drain removal will be included in the study. The drain will be removed during a Valsalva manoeuvre, performed in forced expiration against a closed airway (by instructing the patient to put their thumb in their mouth and blow as if blowing a whistle). The procedure takes approximately 5 seconds and is a one-off event.
Sponsors
St Vincent's Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients who have a single intercostal chest drain in situ and which the treating clinician has determined requires removal. 2. Willingness to give written informed consent and willingness to participate in and comply with the study.
Exclusion criteria
1.Patients who have any radiological evidence of a residual pneumothorax prior to chest drain removal. 2.Patients who have more than 200mls of residual pleural fluid prior to chest drain removal as estimated on plain chest radiograph. 3.Patients who have had an air leak into the underwater seal within 24 hours prior to chest drain removal. 4.Patients with resting hypoxaemia (defined as a partial pressure of oxygen - PaO2 - of less than 55mmHg or saturation - SaO2 - of less than 90% on room air prior to the removal of the chest drain). 5.Patients who have undergone a pleurodesis procedure. 6.Patients who have more than one chest drain in situ at the time when one drain is to be removed. This applies to bilateral drains in patients who have undergone bilateral lung or heart-lung transplantation as these patients have a continuous communication between right and left hemithoraces; however once there is only one remaining drain for removal these patients would then become eligible for inclusion in the study. 7.Patients who are unable to clearly understand or comply with the nurse’s instructions with regard to the technique of breath holding during the removal of the chest drain.
Outcome results
None listed