Evaluation of Fluid Output Threshold for Safe Chest Tube Removal - A Potential Way to Decrease Length of Stay in Hospital and to Improve Postoperative Care After Lung Surgery?

Insel Gruppe AG, University Hospital Bern

Status: Completed

Conditions: Pulmonary Resection; Pleural Effusion Recurrence; Chest Tube Management

Treatments: Procedure: Traditional; Procedure: Test

Study type: Interventional

Funder types: Other

Identifiers

NCT03093610

14032017

Details and patient eligibility

About

Previous studies have shown that the removal of the chest tube after lung surgery significantly improves pain symptoms and lung function. The criteria for chest tube removal still remain vague in modern thoracic surgery and rely on personal experience instead of evidence-based criteria. Every hospital has its own traditional standard fluid threshold and believes in that without adapting and comparing it not even after introduction of newer and more minimal-invasive operation technique. According to literature the traditional fluid threshold is varying from 100 to 500 or even more millilitre in 24 hours. Since pleural fluid resorption is proportional to body weight the investigators believe that a body weight related approach of chest tube management would improve safety and would allow an earlier chest tube removal without a higher rate of complication. In this way the investigators believe in improving pain management and in achieving earlier discharge of the patient.

Enrollment: 337 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Lobectomy/ Bilobectomy
• Segmentectomy
• Signed consent
• Age of majority

Exclusion criteria

• Pneumonectomy
• Atypical resections
• Empyema
• Pleural effusion (not related to surgery)
• Pleurodesis
• Pregnancy

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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337 participants in 2 patient groups

Traditional

Active Comparator group

Description:

The chest tube in the traditional Group will be managed according to the current Guidelines of the investigators' department.

Treatment:

Procedure: Traditional

Test group

Active Comparator group

Description:

The chest tube in the "Test Group" will constitute the experimental Group. The chest tube will be removed when the fluid production over 24h has reached a weight related threshold.

Treatment:

Procedure: Test