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    A randomised controlled trial of intrapleural balloon intercostal chest drains to prevent drain displacement

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    Author
    Cox, Giles
    Keyword
    Chest drain displacement
    Intrapleural balloon
    Randomised controlled trial
    
    Metadata
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    Publisher's URL
    https://erj.ersjournals.com/content/early/2021/11/25/13993003.01753-2021.long
    Abstract
    Background: Chest drain displacement is a common clinical problem, occurring in 9-42% of cases and results in treatment failure or additional pleural procedures conferring unnecessary risk. A novel chest drain with an integrated intrapleural balloon may reduce the risk of displacement. Methods: Prospective randomised controlled trial comparing the balloon drain to standard care (12 F chest drain with no balloon) with the primary outcome of objectively-defined unintentional or accidental chest drain displacement. Results: 267 patients were randomised (primary outcome data available in 257, 96.2%). Displacement occurred less frequently using the balloon drain (displacement 5/128, 3.9%; standard care displacement 13/129, 10.1%) but this was not statistically significant (Odds Ratio (OR) for drain displacement 0.36, 95% CI 0.13 to 1.0, χ2 1df=2.87, p=0.09). Adjusted analysis to account for minimisation factors and use of drain sutures demonstrated balloon drains were independently associated with reduced drain fall out rate (adjusted OR 0.27, 95% CI 0.08 to 0.87, p=0.028). Adverse events were higher in the balloon arm than the standard care arm (balloon drain 59/131, 45.0%; standard care 18/132, 13.6%; χ2 1df=31.3, p<0.0001). Conclusion: Balloon drains reduce displacement compared with standard drains independent of the use of sutures but are associated with increased adverse events specifically during drain removal. The potential benefits of the novel drain should be weighed against the risks, but may be considered in practices where sutures are not routinely used.
    Citation
    Mercer, R. M. et al. (2021) ‘A randomised controlled trial of intrapleural balloon intercostal chest drains to prevent drain displacement’, The European respiratory journal.
    Publisher
    European Respiratory Journal
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15062
    Collections
    Respiratory Medicine

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