Chest drainage insights

Advancing patient recovery with digital chest drainage systems

Time to read: 3 min.

For more than 10 years now, digital chest drainage systems have been providing clear benefits to patients following lung or cardiac surgery—including improved recovery times and patient outcomes. And yet, adoption of digital by many healthcare institutions remains slow.

Why is this? The comfort and familiarity care teams have with traditional analog chest drainage systems likely plays a role. But even if you are satisfied with your existing system, it is important to recognize how digital alternatives can help overcome key challenges with analog systems and improve your patient’s recovery.

Where analog comes up short

It’s not that analog systems cannot be effective—they can be. But they are not optimized to streamline care and support improved outcomes.

This is largely a result of the challenges inherent in most analog systems, which include:1-2

  • Inconsistent delivery of negative pressure – the amount of pressure applied may deviate from preset levels depending on the accuracy of the suction regulator, where the device is placed, fluid in the tubing, and other variables.
  • Sporadic data collection – air leak data can only be obtained when surgeons or nurses are actively checking for bubbling in the water seal chamber.
  • Subjective interpretation – members of the care team may come away with conflicting assessments of air leak severity or if one is even occurring at all.
  • Patient discomfort – studies have shown that many patients are less comfortable with traditional analog chest drainage systems.
  • Suboptimal chest tube duration/hospital length of stay – the amount of time a chest tube remains in place and a patient’s length of stay may be acceptable – but still less than ideal.
  • Human factors that influence efficacy - traditional systems require constant monitoring to make sure there is no leak in the system and care must be taken to ensure the unit is not accidentally knocked over or disconnected.

How digital chest drainage systems advance care

Digital chest drainage systems deliver proven benefits to patients, care teams, and a healthcare institution’s bottom line. When weighing the pros and cons of any system, consider the following 3 ways in which digital can help advance cardiothoracic care:

1. Improving outcomes with continuous data.

Digital systems capture and display data continuously, enabling cardiothoracic surgeons and nurses to make fast, informed clinical decisions – thereby improving outcomes. Digital systems can also improve care efficiencies by: 1-2

  • Strictly regulating and maintaining intrapleural pressure within a set range for therapeutic consistency (versus higher pressure variability/inconsistency with analog systems).
  • Delivering real-time air leak and fluid trending data over a 72-hour period.
  • Eliminating subjective interpretations of bubbling in the water seal with analog systems
  • Unifying hospital practices and protocols by use of objective data.
  • Transferring patient data from the device to computer systems for analysis and documentation.

2. Creating more positive patient experiences.

Cardiothoracic patients with chest drainage systems have expressed concerns around mobility, convenience, and comfort with analog systems.

In contrast, 100% of patients reported a more positive experience with digital chest drainage systems, according to a clinical study.1

Specific areas where patients reported a superior experience with digital included:1

  • Their ability to get up out of bed (p=0.008).
  • Improved convenience for themselves – and the teams caring for them (p=0.02).

3. Reducing chest tube duration/length of stay.

With digital chest drainage systems, care teams can more accurately determine when it is time to pull the drain, which results in shorter chest tube duration compared with analog systems. As a consequence, patient length of stay in the hospital is significantly reduced – as are the subsequent healthcare costs.

Across the board, digital chest drainage systems achieved significantly shorter:1

  • Air leak duration versus analog systems (1.0 and 2.2 days, respectively; p=0.001)
  • Chest tube duration versus analog systems (3.6 and 4.7 days, respectively; p=0.0001)
  • Postoperative length of stay versus analog systems (4.6 and 5.6 days, respectively; p<0.0001)

Choose a proven digital chest drainage system

Clearly, digital chest drainage systems can help deliver superior care. But not all digital systems are created equal. It’s important to select one with proven data in cardiothoracic patients.

Thopaz+ by Medela is such a system. It was specifically designed for the application of optimal negative pressure for post-operative chest drainage management and to permit objective and reliable monitoring of patient status. Thopaz was the digital system that was used in the comparative studies cited above, resulting in a more positive patient experience and shorter air leak duration, chest tube duration, and hospital length of stay.

In addition, Thopaz+:4-8

  • Allows for significant cost savings per patient.
  • Improves safety for patients with chest drains.
  • Improves inter-observer agreement due to precise air leak monitoring.
  • Improves clinical decision-making through continuous, objective monitoring.
  • Increases patient mobility with a system that can be placed above chest height.
  • Provides greater convenience and ease-of-use to healthcare staff than traditional chest drainage systems.
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1 Pompili C, Detterbeck F, Papagiannopoulos K, et al. Multicenter International Randomized Comparison of Objective and Subjective Outcomes Between Electronic and Traditional Chest Drainage Systems. Ann Thorac Surg 2014;98(2):490–7.

2 Miller DL, Helms GA, Mayfield WR. Digital Drainage System Reduces Hospitalization After Video-Assisted Thoracoscopic Surgery Lung Resection. Ann Thorac Surg 2016;102(3):955–61.

3 French DG, Plourde M, Henteleff H, et al. Optimal Management of Postoperative Parenchymal Air Leaks. J Thorac Dis 2018;10(32):3789–98.

4 Pompili C, Brunelli A, Salati M, et al. Impact of the learning curve in the use of a novel electronic chest drainage system after pulmonary lobectomy: a case-matched analysis on the duration of chest tube usage. Interact Cardiovasc Thorac Surg 2011;13(5):490–3.

5 Jablonski S, Brocki M, Wawrzycki M, et al. Efficacy assessment of the drainage with permanent airflow measurement in the treatment of pneumothorax with air leak. Thorac Cardiovasc Surg 2014;62(6):509–15.

6 Mier JM, Molins L, Fibla JJ. The benefits of digital air leak assessment after pulmonary resection: prospective and comparative study. Cir Esp 2010;87(6):385–9.

7 Lijkendijk M, Licht PB, Neckelmann K. Digital versus analogue chest tube drainage following lobectomy: a randomized trial. Interact Cardiovasc Thorac Surg 2014;19 (Supplement 1):31.

8 Varela G, Jiménez MF, Novoa NM, et al. Postoperative chest tube management: measuring air leak using an electronic device decreases variability in the clinical practice. Eur J Cardiothorac Surg 2009;35(1):28–31.

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