Effect of Chest Tube Suction on Air-Leak Following Lung Resection

Air-leak is of the common complications of pulmonary resection, yet there is no consensus on its management. Some authors are in the belief that if, after surgery the lung can remain open, absence of suction will quickly stop the air-leak from the chest tube, whereas others believe that using the suction is essential. This study aims to evaluate the role of chest tube suction after surgery. This is a randomized clinical trial performed on 31 patients who underwent different lung surgeries. After surgery, chest tubes of all patients was connected to the suction till the next morning. Afterwards suction was discontinued for 3 hours and chest radiography was obtained. In presence of pneumothorax in chest-x-ray or in cases of air- leakage from the chest tube, use or no use of chest tube suction was determined randomly. In 13 out of 31 patients, chest tube suction was used. In these patients, adding the suction had no effect on shortening the duration of air-leak or hospital stay. We also tried to evaluate the probable effective causes of air-leak in these patients. In this regard we did not find any relation between the age, FEV1 and PaO2 before the operation with air- leakage after the surgery. But there was a significant correlation between the rate of air-leakage and PaCO2 before the surgery. Risk of air-leakage on the 7th day after surgery was greater in those patients in whom the degree of air-leakage was higher on the first day. Use of chest tube suction had no effect on controlling the air-leakage. In this study, use of chest tube suction had no effect on shortening the air- leak period after surgery. In our patients, PaCO2 was an important factor in predicting the risk of air-leak from the chest tube. (Tanaffos 2006; 5(1): 37-43)