title: Negative pleural suction in thoracic trauma patients: A randomized controlled trial.
abstract: BACKGROUND
  The study aimed to establish the benefits of using chest tubes with negative pleural suction against trapped water in patients with penetrating or blunt chest trauma who underwent tube thoracostomy, in terms of the incidence of complications, such as persistent air leak, clotted hemothorax, empyema, and duration of stay.
  
  
  METHODS
  Patients who underwent tube thoracostomy because of traumatic pneumothorax, hemothorax, or hemopneumothorax were randomly assigned into one of two groups: in Group 1, the three-bottle drainage system was connected to a negative suction; in Group 2, no suction was given. Patients who required mechanical ventilation or emergency surgery (thoracotomy or thoracoscopy) either at the time of admission to the institution or immediately after the tube thoracostomy, patients who had histories of thoracic procedures or chronic pulmonary diseases (chronic obstructive pulmonary disease, diffuse interstitial lung disease), and patients with multiple injuries with severe traumatic brain injury and a Glasgow Coma Scale (GCS) score less than 8 of 15 were excluded from the study. Hospital stay, duration of tube thoracostomy, prolonged fistula, and other clinical variables were compared.
  
  
  RESULTS
  One hundred ten patients were included, 56 in the group with suction and 54 in the group without suction. There were no differences in the demographic characteristics of each group. There were no differences between the groups in terms of hospital stay (p = 0.22), duration of tube thoracostomy (p = 0.35) (3 days in each group), or complications. However, the probability of air leak presence in time was greater for the Group 1 patients with negative suction versus the Group 2 patients (p = 0.023).
  
  
  CONCLUSIONS
  The use of negative pleural suction did not demonstrate advantages over the three-bottle chest drainage system without suction in patients with uncomplicated traumatic pneumothorax, hemothorax, or hemopneumothorax.
  
  
  METHODS
  Therapeutic study, level II.
authors: From the Department of Surgery (C.H.M., C.M., L.A.R., M.F.S., A.F.D.) Universidad de Antioauia; and St. Vincent Paul University Hospital (HUSVP) (C.H.M.), Medellin, Colombia.
authors: Carlos H
authors: CH
authors: Morales
authors: Camila
authors: C
authors: Mejía
authors: Luis Alberto
authors: LA
authors: Roldan
authors: Maria Fernanda
authors: MF
authors: Saldarriaga
authors: Andres Felipe
authors: AF
authors: Duque
mesh_terms: D000328:Adult; D015505:Chest Tubes / Q000009:adverse effects; D005260:Female; D006468:Hemopneumothorax / Q000628:therapy; D006491:Hemothorax / Q000628:therapy; D006801:Humans; D007902:Length of Stay; D008297:Male; D011030:Pneumothorax / Q000628:therapy; D013396:Suction / Q000009:adverse effects / Q000379:methods*; D013898:Thoracic Injuries / Q000628:therapy*; D013906:Thoracoscopy; D013908:Thoracotomy; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000628:therapy; D014950:Wounds, Penetrating / Q000628:therapy