Removal of Chest Tubes: a Prospective Randomized Study

Abstract

Background: This study aims to determine which method and timing of chest tube removal is associated with a lower risk of developing recurrent pneumothorax. Methods: This prospective study was designed to evaluate the removal method and time in 144 patients (57 females, 87 males; mean age 43.2 years; range 8 to 72 years) with chest tubes inserted for trauma and other causes. Patients were randomly assigned into two groups according to the respiratory phase of the chest tube removal. Subgroups were assigned by subdividing these groups according to whether or not suction was performed and according to whether chest tube removal occurred at 6-12 hours or 24-48 hours. Results: Results supported that tube removal at the end-inspiration phase is more appropriate than removal at the end-expiration and no suction phases (p<0.013). In addition, recurrent pneumothorax was observed significantly more often in patients whose chest tubes which were removed at 6-12 hours rather than at 24-48 hours (p<0.028). The mean duration of hospital stay was significantly longer in patients with recurrent pneumothorax (p<0.01). Conclusion: Removal of chest tubes at the end of inspiration with suction and after 24-48 hours is associated with a lower rate of recurrence of pneumothorax and a significantly shorter duration of hospital stay.