title: How long should you wait for a chest radiograph after placing a chest tube on water seal? A prospective study.
abstract: 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.
authors.affiliation: DeWitt Daughtry Family Department of Surgery, Divisions of Trauma/Surgical Critical Care, University of Miami School of Medicine, Florida, USA.
authors.forename: Carl I
authors.initials: CI
authors.lastname: Schulman
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Cohn
authors.forename: Lorne
authors.initials: L
authors.lastname: Blackbourne
authors.forename: Dror
authors.initials: D
authors.lastname: Soffer
authors.forename: Noah
authors.initials: N
authors.lastname: Hoskins
authors.forename: Natasha
authors.initials: N
authors.lastname: Bowers
authors.forename: Fahim
authors.initials: F
authors.lastname: Habib
authors.forename: Bruce
authors.initials: B
authors.lastname: Crookes
authors.forename: Bob
authors.initials: B
authors.lastname: Benjamin
authors.forename: Louis R
authors.initials: LR
authors.lastname: Pizano
mesh_terms: 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