Authors (including presenting author) :
Chan JYH(1), Yu ELM(2), Yeung YC(1), Yu WC(1)
Affiliation :
(1)Department of Medicine & Geriatrics, Princess Margaret Hospital,(2)Clinical Research Centre, Princess Margaret Hospital
Introduction :
Chest drain insertion is need for the treatment of most cases of spontaneous pneumothoraces. Clamping the chest drain for a certain time period before removal may avoid re-insertion of the drain if early recurrence is detected, but may prolong hospital stay. Some authors claim that clamping may be unsafe. There is no clear recommendation in international management guidelines.
Objectives :
To examine the incidence of early recurrence in both clamped and non-clamped pneumothorax episodes, and factors associated with it.
Methodology :
Retrospective chart review of spontaneous pneumothorax episodes (both primary and secondary) in which chest drain was inserted and removed in PMH during the period April 2012 to March 2014
Result & Outcome :
Data of 122 episodes were analysed. There were 36 primary pneumothorax and 86 secondary pneumothorax episodes. Mean age was 59 years with 92% males. Clamping of the chest drain was performed in 68 episodes (55.7%). Clamped and non-clamps groups had similar demographic and disease characteristics. Recurrence within 24 hours were seen in 12 clamped episodes and 4 non-clamped episodes, although in only eight episodes were re-insertion of chest drain saved. Significantly more recurrent pneumothorax episodes were seen in the early recurrence group. We observed no new onset of tension pneumothorax or subcutaneous emphysema associated with clamping.
The practice of clamping the chest drain before removal in spontaneous pneumothorax is safe. If observed for up to 24 hours, clamping has the potential to save chest drain re-insertion in 13% of cases.
