title: Chest tube drainage of pleural effusions--an audit of current practice and complications at Hutt Hospital.
abstract: OBJECTIVE
  The aims of the study were to review small-bore chest tube insertion practices for drainage of pleural fluid at Hutt Valley District Health Board (HVDHB), to assess complications, and compare the findings with international data.
  
  
  METHODS
  Retrospective analysis of clinical records was completed on all chest tube insertions for drainage of pleural fluid at HVDHB from December 2008 to November 2009. Descriptive statistics were used to present demographics and tube-associated complications. Comparison was made to available similar international data.
  
  
  RESULTS
  Small-bore tubes comprised 59/65 (91%) chest tube insertions and 23/25 (92%) complications. Available comparative data was limited. Ultrasound was used in 36% of insertions. Nearly half of chest drains placed for empyema required subsequent cardiothoracic surgical intervention.
  
  
  CONCLUSIONS
  Chest drain complication rates at HVDHB were comparable to those seen internationally. Referral rates to cardiothoracic surgery for empyema were within described ranges. The importance of procedural training for junior medical staff, optimising safety of drain insertions with ultrasound guidance, and clear clinical governance for chest tube insertions are important in minimising harm from this procedure. Specialist societies need to take a leadership in providing guidance on chest drain insertions to secondary and tertiary hospitals in Australia and New Zealand.
authors.affiliation: St. Vincent's Health, Melbourne, Australia.
authors.forename: Erica
authors.initials: E
authors.lastname: Epstein
authors.forename: Sisira
authors.initials: S
authors.lastname: Jayathissa
authors.forename: Stephen
authors.initials: S
authors.lastname: Dee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015505:Chest Tubes / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009520:New Zealand; D010996:Pleural Effusion / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013396:Suction / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult