title: Multicenter international randomized comparison of objective and subjective outcomes between electronic and traditional chest drainage systems.
abstract: BACKGROUND
  The aim of this study was to assess the impact of digital versus traditional drainage devices on chest tube removal and patient satisfaction.
  
  
  METHODS
  A randomized trial of digital versus traditional devices after lobectomy/segmentectomy was conducted at 4 international centers (United Kingdom, Europe, Asia, United States). Patients were managed with overnight suction followed by gravity drainage. Chest tubes were removed when an air leak was not evident anymore and the drained fluid was less than 400 mL/d.
  
  
  RESULTS
  The groups (digital, 191 patients; traditional, 190 patients) were well matched for baseline and surgical characteristics. There were 325 lobectomies/bilobectomies and 56 segmentectomies, 308 of which were performed by video-assisted thoracic surgery (VATS). Patients randomized to digital systems had a significantly shorter air leak duration (1.0 versus 2.2 days; p=0.001), duration of chest tube placement (3.6 versus 4.7 days; p=0.0001), and postoperative length of stay (4.6 versus 5.6 days; p<0.0001). Subjective end points revealed a perceived improved ability to arise from bed (p=0.008), system convenience for patients and personnel (p=0.02), and the potential for being comfortable when discharged home with the device (p=0.06). A mean difference of 2.6 days from air leak cessation to tube removal was observed, which was similar in the 2 groups (p=0.7). Multivariable regression analysis showed that duration of chest tube placement after air leak cessation was directly associated with the amount of fluid drained during the first 48 hours (p=0.01) and the duration of air leak (p=0.008), independent of hospital location.
  
  
  CONCLUSIONS
  Patients managed with digital drainage systems experienced a shorter duration of chest tube placement, shorter hospital stays, and higher satisfaction scores compared with those managed with traditional devices. (
  
  
  BACKGROUND
  NCT01747889.).
authors.affiliation: Department of Thoracic Surgery, Ospedali Riuniti Ancona, Ancona, Italy. Electronic address: ceciliapompili@gmail.com.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Pompili
authors.affiliation: Department of Thoracic Surgery, Yale-New Haven Hospital, Yale University, New Haven, Connecticut.
authors.forename: Frank
authors.initials: F
authors.lastname: Detterbeck
authors.affiliation: Division of Thoracic Surgery, St. James's University Hospital, Leeds, United Kingdom.
authors.forename: Kostas
authors.initials: K
authors.lastname: Papagiannopoulos
authors.affiliation: Department of Thoracic Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
authors.forename: Alan
authors.initials: A
authors.lastname: Sihoe
authors.affiliation: Division of Thoracic Surgery, St. James's University Hospital, Leeds, United Kingdom.
authors.forename: Kostas
authors.initials: K
authors.lastname: Vachlas
authors.affiliation: Department of Thoracic Surgery, Yale-New Haven Hospital, Yale University, New Haven, Connecticut.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Maxfield
authors.affiliation: Department of Thoracic Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
authors.forename: Henry C
authors.initials: HC
authors.lastname: Lim
authors.affiliation: Division of Thoracic Surgery, St. James's University Hospital, Leeds, United Kingdom.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Brunelli
mesh_terms: D000368:Aged; D004322:Drainage / Q000295:instrumentation* / Q000379:methods*; D055615:Electrical Equipment and Supplies; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011013:Pneumonectomy; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome