title: Randomized trial of digital versus analog pleural drainage in patients with or without a pulmonary air leak after lung resection.
abstract: OBJECTIVE
  An unclear aspect of digital pleural drainage technology is whether it can benefit all lung resection patients or only those who have a postoperative air leak. The aim of this study was to evaluate the impact of digital pleural drainage on time to chest tube removal and length of hospitalization, taking into consideration postoperative air leak status.
  
  
  METHODS
  A single-center, randomized, controlled, open-label, parallel-group trial was conducted. On postoperative day 1, stratification according to air leak status was performed by 2 independent, blinded observers. Patients were randomized to a water-sealed, pleural drainage device (analog) or to a digital device (digital).
  
  
  RESULTS
  In both air leak groups (no air leak = 87; air leak = 85), patient factors and operative details were comparable. In the no air leak group, the difference in median chest tube drainage between analog and digital randomization arms was not statistically significant (3 days vs 2.9 days; P = .05). Median length of stay was also comparable in that group (analog = 4.3 days; digital = 4 days; P = .09). In patients with an air leak, similar findings were observed for chest tube duration (analog = 5.6 days; digital = 4.9 days; P = .11) and length of stay (analog = 6.2 days; digital = 6.2 days; P = .36). Chest tube clamping trials were significantly reduced in the digital arm of the air leak absent (0% vs 16%; P = .01) and air leak present groups (23% vs 50%; P = .01).
  
  
  CONCLUSIONS
  Although digital devices decreased tube clamping trials, the impact on duration of chest tube drainage and hospital stay was not statistically significant, even after stratifying by postoperative air leak status.
authors.affiliation: Division of Thoracic Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Electronic address: sgilbert@toh.on.ca.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Gilbert
authors.affiliation: Division of Thoracic Surgery, University of British Columbia, Vancouver, British Columbia.
authors.forename: Anna L
authors.initials: AL
authors.lastname: McGuire
authors.affiliation: Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Sonam
authors.initials: S
authors.lastname: Maghera
authors.affiliation: Division of Thoracic Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Sudhir R
authors.initials: SR
authors.lastname: Sundaresan
authors.affiliation: Division of Thoracic Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Seely
authors.affiliation: Division of Thoracic Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Donna E
authors.initials: DE
authors.lastname: Maziak
authors.affiliation: Division of Thoracic Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Farid M
authors.initials: FM
authors.lastname: Shamji
authors.affiliation: Division of Thoracic Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: P James
authors.initials: PJ
authors.lastname: Villeneuve
mesh_terms: D000368:Aged; D060666:Airway Extubation / Q000295:instrumentation; D015505:Chest Tubes; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009864:Ontario; D011013:Pneumonectomy / Q000009:adverse effects*; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: chest tubes; drainage; humans; length of stay; pleura; prospective study; randomized controlled trial