Outcome Following Chest Tube Removal with Respect to Phase of Respiration in Chest Trauma Patients: A Randomised Controlled Trial
Introduction: Chest tube placement remains amongst the most performed emergency procedure in trauma patients to drain blood or air from the pleural space. After evacuation of pleural contents, removal of chest tube is equally important since its careless removal can cause serious complications like...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2025-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&volume=19&issue=8&page=PC16&issn=0973-709x&id=21384 |
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| Summary: | Introduction: Chest tube placement remains amongst the most performed emergency procedure in trauma patients to drain blood or air from the pleural space. After evacuation of pleural contents, removal of chest tube is equally important since its careless removal can cause serious complications like Recurrent Pneumothorax (RP) and even lung collapse. There is no consensus in the available literature about the phase of respiration favourable for the removal of chest tube.
Aim: To compare the outcome in terms of complications like RP following chest tube removal with respect to phase of respiration in chest trauma patients and risk factors responsible for development of these complications.
Materials and Methods: The present study was a randomised controlled trial conducted at the Department of Surgery, Pt. BD Sharma Post Graduate Institute of Medical Sciences, Rohtak, India, between 1st August 2020 and 31st July 2022. Total one hundred and forty-six patients presenting in emergency with thoracic trauma requiring intercostal intubation were initially enrolled in the study; out of which 20 patients were excluded based on exclusion criteria. The remaining patients were randomised into case group (group EI) in which chest tube was removed at end of inspiration and control group (group EE) in which chest tube was removed at end of expiration with 63 patients in each group. Complications after chest tube removal were noted and possible risk factors for development of these complications were analysed.
Results: A total of 146 patients participated in the study of which the majority of the patients were male (n=54 in EE group and 58 in EI group) in both the groups and the distribution of gender in both the groups was comparable. Mean age for the patients in EE group was 38.71±15.23 years and EI group was 41.35±14.91 years and was statistically comparable. 10 (15.87%) patients in EE group and 9 (14.29%) patients in EI group developed complications and the difference was statistically not significant (p=0.803). Factors like duration between trauma and placement of chest tube, Thoracic Trauma Severity Score (TTSS), duration of intercostal drainage in situ, mechanism of injury and presence of air leak were noted however none of these factors showed statistical significance for development of complications in both the groups.
Conclusion: It is safe to remove chest tube at the end of inspiratory as well as expiratory phase of respiration without any additional risk of complications irrespective of mechanism of injury, duration of chest tube in situ, presence of air leak, duration between trauma and chest tube insertion and TTSS. However, immediate and complete sealing of the entry site after removal of chest tube helps in minimising the risk of complications. |
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| ISSN: | 2249-782X 0973-709X |