Bubbles-in-the-chamber vs digital screen in chest drainage: A blind analysis of compared postoperative air leaks evaluation

Background: Chest drainage systems are affected by intra and inter-observer variability and poor sensibility in detecting minimal or apparent air leaks. Objectives: Overcome intra and inter-observer variability in detecting air leaks. Methods: After surgery, a single apical chest tube was connected to the Drentech™ PalmEVO device and air leaks were checked twice a day by observation of both bubbles-in-the-chamber and digital data. Results: On a total of 624 observations, disagreement between digital and traditional systems was recorded in 60(9.6%) cases. In 25(21.4%) patients, a disagreement was recorded. Overall, the digital evaluation influenced clinical management in 13(52%). In 10(40%) patients with temporary discordant features, the presence of high pleural fluid output led to a progressive final concordance. Conclusions: Disagreement between traditional and digital systems in checking air leaks is not negligible. Digital systems could give advantages in making an objective assessment of air leaks, standardizing the timing of chest tube removal.