title: A survey of percutaneous chest drainage practice in French university surgical ICU's.
abstract: OBJECTIVE
  Percutaneous chest drainage guidelines were published in 2010 by the British Thoracic Society. On several points (insertion technique, drain size), they seem to differ from French practices. Our objectives were to evaluate practice of pleural drainage in French University surgical intensive care units (ICU's), and to compare it with the British guidelines.
  
  
  METHODS
  National phone survey.
  
  
  METHODS
  Physicians working in 58 ICU's were surveyed first in 2007, and subsequently in 2012. They were read a questionnaire to evaluate the demographic characteristics of their units, their indication for pleural drainage, how they quantified pleural effusion, and their technique for drain insertion. Data from the two surveys were compared to detect an evolution in practice following the publication of the British guidelines. Results are expressed as the mean response.
  
  
  RESULTS
  In 2007, pleural drainage indications relied on various respiratory criteria in 91% of cases (versus 95% in 2012) and/or on pleural effusion volume in 71% of cases (versus 59% in 2012). Trocars (Monod or Joly) were used in 68% of the procedures in 2007. In the rest, either blunt dissection, a Pleurocath® or the Seldinger technique was utilized. From 2007 to 2012, the Seldinger technique increased in frequency (10% versus 22%, P=0.005) while Monod trocar usage decreased (41% vs 29%, P=0.012). Ultrasound before pleural effusion drainage became nearly systematic in 2012 (60% vs 86%, P<0.001).
  
  
  CONCLUSIONS
  The frequent use of trocar (and therefore of large drains) for pleural drainage in French ICU's differs significantly from the British guidelines.
authors.affiliation: Pôle anesthésie réanimation Samu, université François Rabelais, CHRU de Tours, 37044 Tours cedex 9, France. Electronic address: f.remerand@chu-tours.fr.
authors.forename: F
authors.initials: F
authors.lastname: Remérand
authors.affiliation: Pôle anesthésie réanimation Samu, université François Rabelais, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Bazin
authors.affiliation: Pôle anesthésie réanimation Samu, université François Rabelais, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: J
authors.initials: J
authors.lastname: Gage
authors.affiliation: Pôle anesthésie réanimation Samu, université François Rabelais, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Laffon
authors.affiliation: Pôle anesthésie réanimation Samu, université François Rabelais, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: J
authors.initials: J
authors.lastname: Fusciardi
mesh_terms: D015505:Chest Tubes / Q000706:statistics & numerical data*; D003422:Critical Care / Q000379:methods* / Q000592:standards*; D004322:Drainage / Q000295:instrumentation / Q000592:standards* / Q000706:statistics & numerical data; D005602:France; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D010820:Physicians; D013525:Surgical Instruments
keywords: Drainage pleural; Intensive care; Pleural drainage; Pleural effusion; Pleurésie; Réanimation; Thoracic tube; Trocar; Trocart; Tube thoracostomy