"LOW-PRESSURE, HIGH IMPACT”: A RANDOMIZED CONTROLLED TRIAL OF “IMPACT OF LOW-PRESSURE NEGATIVE PLEURAL SUCTION VERSUS UNDERWATER SEAL DRAINAGE IN THORACIC TRAUMA” vaibs9@yahoo.com

 

"LOW-PRESSURE, HIGH IMPACT”: A RANDOMIZED CONTROLLED TRIAL OF “IMPACT OF LOW-PRESSURE NEGATIVE PLEURAL SUCTION VERSUS UNDERWATER SEAL DRAINAGE IN THORACIC TRAUMA”

3

India

Oral only

Thoracic trauma is a major contributor to morbidity and mortality in trauma patients, commonly leading to conditions like pneumothorax, hemothorax, and hemopneumothorax. Standard management involves intercostal chest tube drainage, typically using an underwater seal drainage (UWSD) system. This study evaluates the effectiveness of low-pressure negative pleural suction compared to UWSD in improving clinical outcomes.

This open-label, randomized controlled trial was conducted at a Level I trauma centre (KGMU, Lucknow) over one year. A total of 102 patients with traumatic pneumothorax, hemothorax, or hemopneumothorax were randomized into two groups: Group I (n=51) received chest drainage with continuous low-pressure suction (-20 cm H₂O), and Group II (n=51) received standard UWSD. Primary outcomes included duration of intercostal drainage (ICD), length of hospital stay, and incidence of complications like persistent air leak, clotted hemothorax, and re-intervention requirement.

Group I showed significantly reduced ICD duration (4.1±2.6 vs. 6.8±2.9 days, p=0.045), clotted hemothorax incidence (3.2±1.2 vs. 6.8±1.5 days, p=0.021), and need for re-intervention (2.3±0.8 vs. 6.3±1.2, p=0.001). Although the length of hospital stay was shorter in Group I (8.3±4.1 vs. 9.9±4.6 days), this was not statistically significant.

Conclusion: Low-pressure pleural suction significantly reduces chest tube duration, complications, and re-intervention rates compared to UWSD. These findings support its use as a preferred drainage method in managing thoracic trauma.