Chest Drain Regular Flushing in Complicated Parapneumonic Effusions and Empyemas
Vanderbilt University Medical Center
Summary
Infections of the pleural space are common, and patients require antibiotics and chest drain placement to evacuate the chest from the infected fluid. Chest drains can get blocked by the drainage fluid and material. For this reason, it is thought that flushing the chest drain with saline solution, can help maintain the patency of the tube. This proposed study will evaluate the impact of regular chest drain flushing on the length of time to chest tube removal and total hospitalization as well as improvement in chest imaging and the need for additional interventions on the infected space.
Description
There are no randomized controlled trials (RCTs) evaluating the role of regular chest tube flushing in the setting of pleural space infection for optimal drainage and treatment outcomes. Most studies of \<16 Fr catheters have used both flushing and suction to decrease the likelihood of catheter blockage and improve drainage efficiency, however, this practice has never been studied prospectively or in RCTs. Regular flushing (e.g., 20-30 ml saline every 6 h via a three-way tap) is recommended for small chest drains by the British Thoracic Society (BTS) 2010 Guidelines. This practice is followed…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Patients with complicated parapneumonic pleural effusion and empyema requiring chest tube placement as standard of care for inpatient management of their pleural space infection with or without intrapleural tissue plasminogen activator and deoxyribonuclease therapy * Age \> 18 years old. Exclusion Criteria: * Patients who have surgical tubes that can't accommodate a three-way stopcock. * Study subject has any disease or condition that interferes with the safe completion of the study. * Inability to provide informed consent. * Inability to undergo a chest X-ray. * If th…
Interventions
- OtherSaline Flush
sterile saline 20 mL flushed into their catheter by trained nurses or study team members every 6 ± 2 hours
Locations (5)
- Henry FordSterling Heights, Michigan
- Creighton UniversityOmaha, Nebraska
- Mount SinaiNew York, New York
- Vanderbilt University Medical CenterNashville, Tennessee
- Virginia Commonwealth UniversityRichmond, Virginia