Chadwick A J, Halfyard R, Ali M
John Radcliffe Hospital, Oxford University Hospital NHS Trust, Oxford, UK.
J Intensive Care Soc. 2015 Nov;16(4):312-325. doi: 10.1177/1751143715583856. Epub 2015 Apr 29.
Chest drains are common on intensive care units for a wide variety of clinical conditions. Despite this, there are no published data on their use within the intensive care unit and minimal published literature to guide decision making regarding the timing of their removal. Therefore, we undertook an audit to review our experience over one year, as to the degree of variability in when chest drains were removed. Using our electronic observation records, we assessed the length of stay of our chest drains against their functionality by whether they remained swinging (i.e. in connection with the pleural space) and whether they had a pathological fluid output (>150 mL/24 h). We found that our drains had a mean duration of 5.89 days, and that one-quarter remained in place for three days despite being non-functional. To conclude, we have devised a three-stage assessment (using the acronym I-T-U), to help guide an intensivist in the safe and timely removal of a chest drain.
胸腔引流管在重症监护病房用于多种临床情况时很常见。尽管如此，关于其在重症监护病房的使用尚无已发表的数据，且指导其拔除时机决策的已发表文献极少。因此，我们进行了一项审计，以回顾我们一年多来关于胸腔引流管拔除时间变异性的经验。利用我们的电子观察记录，我们根据胸腔引流管是否仍在摆动（即与胸膜腔相连）以及是否有病理液体输出（>150毫升/24小时）来评估其留置时间与功能的关系。我们发现我们的引流管平均留置时间为5.89天，并且四分之一的引流管尽管已无功能但仍留置了三天。总之，我们设计了一个三阶段评估方法（首字母缩写为I-T-U），以帮助指导重症监护医生安全、及时地拔除胸腔引流管。
