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A randomised controlled trial of intrapleural balloon intercostal chest drains to prevent drain displacement

Mercer, RM; Mishra, E; Banka, R; Corcoran, JP; Daneshvar, C; Panchal, RK; Saba, T; ... Kemp, SV; + view all (2022) A randomised controlled trial of intrapleural balloon intercostal chest drains to prevent drain displacement. European Respiratory Journal , 60 (1) , Article 2101753. 10.1183/13993003.01753-2021. Green open access

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Abstract

BACKGROUND: Chest drain displacement is a common clinical problem, occurring in 9-42% of cases and results in treatment failure or additional pleural procedures conferring unnecessary risk. A novel chest drain with an integrated intrapleural balloon may reduce the risk of displacement. METHODS: Prospective randomised controlled trial comparing the balloon drain to standard care (12 F chest drain with no balloon) with the primary outcome of objectively-defined unintentional or accidental chest drain displacement. RESULTS: 267 patients were randomised (primary outcome data available in 257, 96.2%). Displacement occurred less frequently using the balloon drain (displacement 5/128, 3.9%; standard care displacement 13/129, 10.1%) but this was not statistically significant (Odds Ratio (OR) for drain displacement 0.36, 95% CI 0.13 to 1.0, χ2 1df=2.87, p=0.09). Adjusted analysis to account for minimisation factors and use of drain sutures demonstrated balloon drains were independently associated with reduced drain fall out rate (adjusted OR 0.27, 95% CI 0.08 to 0.87, p=0.028). Adverse events were higher in the balloon arm than the standard care arm (balloon drain 59/131, 45.0%; standard care 18/132, 13.6%; χ2 1df=31.3, p<0.0001). CONCLUSION: Balloon drains reduce displacement compared with standard drains independent of the use of sutures but are associated with increased adverse events specifically during drain removal. The potential benefits of the novel drain should be weighed against the risks, but may be considered in practices where sutures are not routinely used.

Type: Article
Title: A randomised controlled trial of intrapleural balloon intercostal chest drains to prevent drain displacement
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1183/13993003.01753-2021
Publisher version: https://doi.org/10.1183/13993003.01753-2021
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10141016
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