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Pleural Pressure Differences Before Removal Are Greater in Patients Who Develop Residual Pneumothorax Post Chest Drain Removal.
- Source :
-
Journal of investigative surgery : the official journal of the Academy of Surgical Research [J Invest Surg] 2020 Apr; Vol. 33 (4), pp. 295-300. Date of Electronic Publication: 2018 Nov 05. - Publication Year :
- 2020
-
Abstract
- Aim of study: We aimed to investigate whether the difference in pleural pressures (Δ P ) is wider among patients who develop a residual pneumothorax after chest tube removal following lung resection surgery. Materials and methods: Ninety-eight patients who underwent lung resection were included in the study over a period of 12 months. The Δ P prior to chest tube removal in patients who developed a residual pneumothorax after chest tube removal was compared with that of patients who did not develop this complication. The receiver operating characteristic (ROC) curve analysis was performed to identify cutoff values of Δ P for the prediction of residual pneumothorax. Logistic regression analysis was used to formulate a prediction model for the occurrence of residual pneumothorax based on Δ P . Results: Thirteen patients who developed a residual pneumothorax were compared with 85 patients without this complication. The Δ P in the residual pneumothorax group was significantly higher (10.8 versus 4.2 cm H <subscript>2</subscript> O, p < 0.01). The Δ P in patients who required intervention was also significantly higher (14.8 versus 4.2 cm H <subscript>2</subscript> O, p < 0.01). A Δ P cutoff value of 8 cm H <subscript>2</subscript> O was predictive of the occurrence of residual pneumothorax (sensitivity 85.6%, specificity 84.6%) and a value of 12 cm H <subscript>2</subscript> O was predictive of intervention (sensitivity 84%, specificity 85%). Increasing Δ P was an independent predictor of the occurrence of residual pneumothorax ( p = 0.008) on the multivariate logistic regression model. Conclusion: Patients with wide Δ P before chest drain removal may be complicated with residual pneumothorax.
- Subjects :
- Aged
Chest Tubes adverse effects
Drainage instrumentation
Drosophila Proteins
Female
Humans
Male
Middle Aged
Nerve Tissue Proteins
Nuclear Proteins
Pleural Cavity surgery
Pneumothorax physiopathology
Postoperative Complications etiology
Predictive Value of Tests
Pressure
Risk Assessment
Transcription Factors
Treatment Outcome
Device Removal adverse effects
Drainage adverse effects
Pleural Cavity physiopathology
Pneumothorax surgery
Postoperative Complications epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1521-0553
- Volume :
- 33
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of investigative surgery : the official journal of the Academy of Surgical Research
- Publication Type :
- Academic Journal
- Accession number :
- 30395746
- Full Text :
- https://doi.org/10.1080/08941939.2018.1503378