DundeeChest 3.0

Posts Tagged ‘Chest Drain’

Hands up if you want a chest drain....

Well, probably not.  Is bigger better? That is the question (with apologies to Billy Shakespeare) that wafts around the room when discussing the chest drain options for an Empyema.  Long has it been argued that drains of a wider bore ensure complete drainage of tenacious pus from the chest cavity, and sidestep the problem of getting repeatedly blocked.  The pros and cons of both wide bore surgical drains using blunt dissection, and their smaller counterparts inserted with the seldinger technique, are batted back and forth among chest physicians and cardiothoracic surgeons alike.  This recent paper in Chest looks to clarify the issue by looking afresh at the MIST1 trial data and determines that the smaller drains did not lead to increased rate of death, or need for surgery, but were associated with less pain. Their conclusion is that the small drains seem to be doing the job just fine thank you very much, but needless to say a properly designed study looking specifically at this issue is needed. Don’t they always say that?  For a good discussion around the topic I would check out the editorial in the same issue.