How long should you wait for a chest radiograph after placing a chest tube on water seal? A prospective study.
OBJECTIVE
The purpose of this study was to determine the optimal time interval for identifying a pneumothorax (PTX) on chest radiograph (CXR) after placing a chest tube on water seal.


METHODS
One hundred nineteen chest tubes were placed on water seal according to a prospective, observational study protocol. After water seal, both an early (3.1 +/- 2.1 hours) and a late (17.6 +/- 8.0 hours) CXR was obtained.


RESULTS
Thirty-one patients had a PTX on follow-up CXRs. There were 22 early and 9 late PTXs identified. Three patients in the early group had a clinically significant PTX or an increase in the size of PTX on follow-up CXR. None of the patients in the late group had a clinically significant PTX (any worsening of their PTX) or required further intervention.


CONCLUSIONS
A normal chest radiograph obtained 3 hours after placing a chest tube on water seal effectively excludes development of a clinically significant pneumothorax.
Schulman
Carl I
CI
DeWitt Daughtry Family Department of Surgery, Divisions of Trauma/Surgical Critical Care, University of Miami School of Medicine, Florida, USA.
Cohn
Stephen M
SM
Blackbourne
Lorne
L
Soffer
Dror
D
Hoskins
Noah
N
Bowers
Natasha
N
Habib
Fahim
F
Crookes
Bruce
B
Benjamin
Bob
B
Pizano
Louis R
LR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015505:Chest Tubes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D013902:Radiography, Thoracic; D013898:Thoracic Injuries / Q000000981:diagnostic imaging* / Q000628:therapy*; D013997:Time Factors