Abstract
Background: Spontaneous pneumothorax is one of the sudden onset diseases. Therefore, pneumothorax patients frequently visit emergency departments at hospitals. When chest drainage treatment is needed as primary care, the patient requires hospitalization in order to undergo chest drainage treatment. Outpatient treatment improves quality of life of the patients, and shortens their hospital stay. Furthermore it contributes to reducing healthcare costs. Outpatient drainage treatment, however, creates a lot of problems compared with the inpatient treatment. Thoracic Egg® is a portable drainage kit (TE: Sumitomo Bake. Tokyo). Effectiveness, safety, problems and countermeasures in outpatient treatment using TE were clinically examined.
Subjects and Methods: 167 cases with spontaneous pneumothorax visited the Pneumothorax Research Center to undergo outpatient treatment with TE. The indications are as follows. 1. Mild dyspnea or chest pain. 2. A little pleural effusion within a week after the onset. 3. Moderate spontaneous pneumothorax. Drainage tubes were removed if the patient recovered from pneumothorax after seven days. If patients did not recover from pneumothorax, they were followed up with additional assessment for seven days either as inpatient or outpatient.
Results: 137 cases were eligible to complete outpatient treatment with TE. 30 cases were altered to inpatient treatment from the outpatient treatment. 26 cases did not recover fully from pneumothorax. Three patients had hemothorax, and one patient had acute pleuritis caused by contamination. 14 patients had some complications. Two cases of hemothorax and one case of pleural effusion needed hospitalization respectively. The other 11 patients had slight fever but could observe in outpatient treatment.
Conclusion: Patients with TE could be safely managed drainage tube by themselves. It is, however, important that the medical professional should provide full explanation to the patient how the portable drainage tube should be managed, as well as 24 hr on-demand medical care. It is also desirable to improve the safety and efficacy of outpatient drainage kits.
