Postoperative outpatient chest tube management: initial experience with a new portable system.
OBJECTIVE
Prolonged air or fluid chest tube drainage may delay chest tube removal in thoracic surgery patients otherwise ready for discharge. We reviewed 20 months of experience at our institution with postoperative, outpatient chest tube management using a new portable chest tube device.


METHODS
From May 2003 to December 2004, 457 major thoracic procedures were performed at our institution. Besides excessive chest tube output or air leak, 50 patients met the criteria for discharge. There were 36 patients who were discharged with a new portable chest tube system (Express Mini 500; Atrium Medical Corp, Hudson, NH). Patients received written instructions and demonstrated competence on system use. Patients returned for chest tube removal after satisfactory resolution of air leak or fluid drainage.


RESULTS
Postoperative outpatient chest tube management accounted for 404 days. There were no major complications. Four patients experienced minor complications. Thirty-two patients (89%) experienced uneventful and successful outpatient chest tube management.


CONCLUSIONS
These data suggest that successful postoperative outpatient chest tube management can be accomplished in select patients. This program resulted in substantial hospital cost reduction and enhanced patient satisfaction by allowing earlier discharge.
Rieger
Karen M
KM
Thoracic Surgery Division, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana46202, USA. krieger@iupui.edu
Wroblewski
Heather A
HA
Brooks
Jo Ann
JA
Hammoud
Zane T
ZT
Kesler
Kenneth A
KA
D015505:Chest Tubes; D004867:Equipment Design; D006801:Humans; D008171:Lung Diseases / Q000628:therapy; D010045:Outpatients; D011182:Postoperative Care; D011183:Postoperative Complications / Q000628:therapy; D011184:Postoperative Period; D012648:Self Care; D019616:Thoracic Surgical Procedures / Q000379:methods*