An initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery

Abstract

Objective:: To report an initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery.

Methods:: This was a prospective observational study involving consecutive patients, ≤ 14 years of age, treated at a pediatric thoracic surgery outpatient clinic, for whom pulmonary resection (lobectomy or segmentectomy via muscle-sparing thoracotomy) was indicated. The parameters evaluated were air leak (as quantified with the digital system), biosafety, duration of drainage, length of hospital stay, and complications. The digital system was used in 11 children (mean age, 5.9 ± 3.3 years). The mean length of hospital stay was 4.9 ± 2.6 days, the mean duration of drainage was 2.5 ± 0.7 days, and the mean drainage volume was 270.4 ± 166.7 mL. The mean maximum air leak flow was 92.78 ± 95.83 mL/min (range, 18-338 mL/min). Two patients developed postoperative complications (atelectasis and pneumonia, respectively). The use of this digital system facilitated the decision-making process during the postoperative period, reducing the risk of errors in the interpretation and management of air leaks.

Objetivo:: Relatar a experiência inicial com um sistema de drenagem digital no pós-operatório de cirurgia torácica pediátrica.

Métodos:: Estudo observacional e prospectivo envolvendo pacientes consecutivos do ambulatório de cirurgia torácica pediátrica da instituição, com idade até 14 anos, e com indicação de ressecção pulmonar (lobectomia e/ou segmentectomia através de toracotomia poupadora muscular). Os parâmetros avaliados foram perda aérea (quantificada com o sistema digital), biossegurança, tempo de drenagem, tempo de internação e complicações.

Resultados:: O sistema digital foi utilizado em 11 crianças, com média de idade de 5,9 ± 3,3 anos. A média do tempo de internação foi de 4,9 ± 2,6 dias, a de tempo de drenagem foi de 2,5 ± 0,7 dias, e a de volume de drenagem foi de 270,4 ± 166,7 ml. A média da perda aérea máxima foi de 92,78 ± 95,83 ml/min (variação, 18-338 ml/min). Dois pacientes apresentaram complicações pós-operatórias (atelectasia e pneumonia, respectivamente).

Conclusões:: O uso desse sistema digital facilitou a tomada de decisão durante o pós-operatório, diminuindo o risco de erros na interpretação e no manejo da perda aérea.

Figures

Figure 1. In the upper left, a picture of the digital device used. In the upper right and at the bottom, computer-generated data and a computer-generated graph, respectively. This information constitutes the postoperative data of an 8-year-old child who underwent a left upper lobectomy for cystic adenomatoid malformation. The duration of drainage was three days, the maximum air leak flow was 39 mL/min, and the maximum suction pressure used was 23.6 cmH2O. Hospital discharge occurred on postoperative day 4.