Disease relevance of Chest Tubes

• There was a high degree of correlation between clot ratio values and postoperative blood loss (cumulative chest tube drainage in the first 4 postoperative hours) with higher concentrations of PAF: CRCh6 (r = -0.80), %M of CRCh6 (r = -0.82), CRCh5 (r = -0.70), and %M of CRCh5 (r = -0.85) [1].
• Conservative therapy with chest tube drainage and a strict medium-chain triglyceride diet allowed the chylous fistula to spontaneously close without the need for surgical intervention [2].
• CONCLUSION: Although most cases of chylothorax after pulmonary resection with systematic mediastinal lymph node dissection can be cured with a conservative strategy, early surgical intervention may be indicated if chest tube drainage is more than 500 mL during the first 24 hours after complete oral intake cessation and total parenteral nutrition [3].
• CONCLUSIONS: Bleomycin sclerotherapy after small flexible chest-tube drainage of malignant pleural effusions is an effective technique, with minimal adverse reactions, for controlling effusions that develop in women with gynecologic malignancies [4].
• After drainage of the effusion, cisplatin plus cytarabine was administered via the chest tube, achieving complete remission of the pleural effusion [5].

High impact information on Chest Tubes

• INTERVENTION: A chest tube was inserted for drainage of the effusion, and pleurodesis was done using bleomycin as the sclerosant [6].
• In addition, patients taking aspirin or Coumadin required prolonged chest tube drainage compared to those in heparin or control groups (34 +/- 4 versus 20 +/- 1 h) (P less than 0.001) [7].
• Chest tube drainage measured within the first 35 hr after CABG revealed that the median loss with aspirin daily (965 ml), aspirin three times daily (1175 ml), and aspirin plus dipyridamole (1000 ml) exceeded (p less than .02) that with placebo (805 ml), while median loss with sulfinpyrazone (775 ml) did not [8].
• A single dose of cisplatin 100 mg/m2 plus cytarabine 1,200 mg was instilled into the pleural space via a chest tube, which was then immediately removed [9].
• The clopidogrel group had higher 24-h mean chest tube output (1,224 ml vs. 840 ml, p = 0.001), and more transfusions of red blood cells (2.51 U vs. 1.74 U, p = 0.036), platelets (0.86 U vs. 0.24 U, p = 0.001) and fresh frozen plasma (0.68 U vs. 0.24 U, p = 0.015) [10].

Chemical compound and disease context of Chest Tubes

• Three patients with distal bronchopleural fistulas, in whom chest tube and drainage did not lead to closure of the fistulas, were successfully treated with tissue glue (Histoacryl), delivered through a thoracoscope [11].
• Medical therapy with total parenteral nutrition, octreotide, and/or chest tube placement was successful in resolving the pancreaticopleural fistula in up to 33% of cases [12].
• Based upon the data obtained in this review, we recommend that initial management of the pneumothorax include evacuation of the pneumothorax using a chest tube and then chemical pleurodesis using quinacrine sclerosis [13].
• Because no difference in postoperative blood loss was found, the markedly reduced transfusion requirement of the DDAVP-treated patients is explained either by reduced intraoperative bleeding or by a reduced hematocrit of the chest-tube blood.(ABSTRACT TRUNCATED AT 250 WORDS)[14]
• The presence of pericardial effusion in patients after their transplantation did not demonstrate independent correlation with chest tube output after operation, cyclosporine therapy, acute rejection, level of blood urea nitrogen (BUN), infection or preoperative diagnosis of idiopathic dilated cardiomyopathy [15].

Biological context of Chest Tubes

• The purpose of this investigation was to determine the relationship among alterations in the latex agglutination D-dimer assay, use of extracorporeal circulation, type of cardiac surgical procedure, and mediastinal and/or chest tube drainage (cardiac surgery only) in patients undergoing thoracic surgery [16].
• Platelet counts, fibrinogen levels, and thromboelastographic values at baseline and after protamine sulfate administration, number of blood product transfusions, and 6-hour and 24-hour chest tube drainage were used to evaluate the effects of aprotinin on postbypass coagulopathies [17].
• The following anti-coagulation regimen was used: low-molecular-weight Dextran for 1 day, initiated after chest tube drainage <50 cc/hour; then IV heparin for 10 to 14 days, beginning at 500 U/hour, slowly increasing partial thromboplastin time to 1.5 to 2 x control; and finally Coumadin, maintaining the international normalized ratio at 2.5 to 3 [18].
• It appears that the increased systemic venous pressure from left innominate thrombosis leading to superior vena cava obstruction in association with chest tube drainage connected to suction (increased intrapleural negative pressure) produced hydrostatic imbalances that resulted in increased pleural fluid formation and collection [19].

Anatomical context of Chest Tubes

• In an attempt to increase the drainage of the pleural effusion, alteplase 16 mg was administered into the pleural cavity via the chest tube on 6 consecutive days [20].
• Cardiac herniation with catheterization of the heart, inferior vena cava, and hepatic vein by a chest tube [21].
• Medical therapy (chest tube drainage, parenteral alimentation) and thoracic duct ligation at 103 days of age had no effect [22].
• Despite the hematologic differences, serotonin concentration and platelet counts in the pulmonary artery blood had significant correlation to indices of cardiac function and postoperative chest tube drainage, respectively [23].

Associations of Chest Tubes with chemical compounds

• RESULTS--The response to tetracycline sclerotherapy in the two groups was the same (80%) but the duration of chest tube drainage was significantly shorter for patients in group 2 (median two days) than for those in group 1 (median seven days) [24].
• The small calibre chest tube with a one way valve is recommended as a safe and easy technique [25].
• The desmopressin-treated patients in group 2 neither experienced increased mediastinal chest tube drainage nor received increased amounts of homologous blood products when compared to those in group 1.(ABSTRACT TRUNCATED AT 250 WORDS)[26]
• He responded well to chest-tube drainage and antifungal therapy; he received fluconazole as maintenance therapy for 1 year and has not relapsed [27].
• All patients had chest tubes inserted on admission, and all were treated with parenteral antibiotics, which included chloramphenicol in 92% of the patients and cloxacillin in 72% [28].

Gene context of Chest Tubes

• There was a significant difference in duration of chest tube placement between the early and late tPA groups [29].
• METHODOLOGY: Twelve sheep were divided into three groups and were given a single intrapleural dose of TGF-beta2 (0.25 microg/kg), talc slurry (5 g) or bleomycin (60 IU) via a chest tube [30].
• There was no association between recurrence rate and COPD/non-COPD, age or duration of chest tube treatment (1-7 days, 8 days or more) [31].
• Total 8-h chest tube drainage did not correlate with any coagulation test at any time point except with P-selectin expression after protamine administration (r = -0.4; P = 0.03) [32].
• Mean chest tube duration was 6.3 +/- 0.5 days [33].

Analytical, diagnostic and therapeutic context of Chest Tubes

• Factors responsible for improving results include early diagnosis with routine contrast studies on the fifth to seventh postoperative days, mandatory use of total parenteral nutrition, nonoperative management of contained leaks, accurate, aggressive use of adjuvant chest tubes, and selective esophagostomy for anastomotic disruption [34].
• In group 2, significantly depressed CD4 counts (average 33.2 cells/ml3) were noted along with a more prolonged preoperative hospitalization (18.5 days) with 14.2 days spent with a chest tube before the operation [35].
• Modest postoperative chest tube drainage (mean, 784 ml in 48 hours) in these patients provides clinical support for low-dose protamine administration for heparin neutralization at the conclusion of cardiopulmonary bypass [36].
• Treatment consisted of chest tube insertion and 5 days' intravenous infusion of octreotide [37].
• This procedure does not overestimate energy needs when a physiological gas leak exists (high positive-end expiratory pressures and high fractional concentrations of O2 or chest tube) [38].

References