Despite multiple advances in lung resection, including the use of stapling devices, sealants and approaches without fissure dissection, thoracic surgeons continue to be plagued by air leaks. Prolonged air leaks (PAL) have been defined as lasting more than 5 days after surgery ( 2). They result from an alveolar-pleural fistula, and in most instances, will heal spontaneously. Post-lung resection air leaks remain one of the most common complications resulting in delay of hospital discharge ( 1). Keywords: Enhanced recovery after surgery (ERAS) chest drain protocol chest tube management Standardization of postoperative care through ERAS programs will allow for the design of larger RCTs to better understand some of the controversies around the management of postoperative air leaks. There is also literature to support the design of protocols for management of postoperative air leaks.
Pleur evac at home Patch#
The key findings are that a single chest drain is adequate in the majority of cases to manage an air leak, the use of applied external suction is unlikely to prevent or prolong an air leak, autologous blood patch pleurodesis may potentially shorten postoperative air leaks and there is sufficient data to support that patients can safely be discharged with a portable drainage system.
The literature regarding the management of postoperative air leaks, including the number of chest tubes, the role of applied external suction, invasive maneuvers and discharge with a portable device is reviewed. Published data suggests that digital drainage systems result in a more confident assessment of air leaks. Accurate assessment of air leaks using traditional analogues devices, newer digital drainage systems, portable devices and chest X-rays (CXR) are reviewed. ERAS programs should consider two components when creating protocols for air leaks: assessment and management.
Enhanced recovery after surgery (ERAS) programs must be designed to manage parenchymal air leaks.
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