If you'd like to learn more about mobile drainage, chest drain usage and pleural drainage in general, the following references are provided by Atrium for your convenience. Where content is available on the web, links are indicated.

Adrales G, Huynh T, Broering B, et al.: A thoracostomy tube guideline improves management efficiency in trauma patients. Journal of Trauma, Injury, Infection & Critical Care 2002;52:210-216.

Ahrens T, Coleman RH: Ask the Experts: lung volume reduction surgery. Critical Care Nurse 1997;17(1):88-89.

Anderson B, Higgins L, Rozmus C: Critical pathways: application to selected patient outcomes following coronary artery bypass graft. Applied Nursing Research 1999;12(4):168-174.

Antunes G, Neville E, Duffy J, Ali N: BTS guidelines for the management of malignant pleural effusions. Thorax 2003;58(Suppl II):ii29-ii38.

Ayed AK: Suction versus water seal after thoracoscopy for primary spontaneous pneumothorax: prospective randomized study. Annals of Thoracic Surgery 2003;75:1593-1596.

Baumann MH: Less is more? Chest 2001;120(1):1-3.

Baumann MH: What size chest tube? What drainage system is ideal? And other chest tube management options. Current Opinions in Pulmonary Medicine 2003;9:276-281.

Baumann MH, Patel PB, Roney CW, Petrini MF: Comparison of function of commercially available pleural drainage units and catheters. Chest 2003;123:1878-1886.

Baumann MH, Strange C, Heffner JE et al.: Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest 2001;119(2):590-602.

Berger P, Leemans R, Kuiper MA, van der Voort PHJ: Uncommon complications during chest tube placement: a potential role of tube material. Intensive Care Medicine 2003;29:1610-1611.

Broscious SK: Music: an intervention for pain during chest tube removal after open heart surgery. American Journal of Critical Care 1999;8(6):410 415.

Burrows CM, Mathews WC, Colt HG: Predicting survival in patients with recurrent symptomatic malignant pleural effusions. Chest 2000;117(1): 73-78.

Capps JS, Tyler ML, Rusch VW, Pierson DJ: Potential of chest drainage units to evacuate broncho-pleural air leaks. Chest 1985;88S:57S. [classic for discussion of physics]

Carroll P: A guide to mobile chest drains. RN 2002;65(5):56-60,65.

Carroll P: Ask the experts: dry suction chest drainage system. Critical Care Nurse 2003;23(4):73-74.

Carroll P: Chest drainage made easy. RN 1995;58(12):46-56.

Carroll P: Exploring chest drain options. RN 2000;63(10):50-54.

Carroll P: Mobile chest drainage: coming soon to a home near you. Home Healthcare Nurse 2002;20(7):434-441

Carroll PF: Patients with pleural air leaks. Focus on Critical Care 1987;14(3):48-51.

Carroll PL: The principles of vacuum and its use in the hospital environment. 1995. Ohmeda, Inc.; Columbia, MD.

Carson MM, Barton DM, Morrison CC, et al: Managing pain during mediastinal chest tube removal. Heart & Lung 1994;22(4):134-146.

Cerfolio RJ, Bass C, Katholi CR: Prospective randomized trial compared suction versus water seal for air leaks. Annals of Thoracic Surgery 2001;71(5):1613-1617.

Cerfolio RJ, Pickens A, Bass C, Katholi C: Fast-tracking pulmonary resections. Journal of Thoracic and Cardiovascular Surgery 2001; 122(2):318-324.

Cheng, D: Randomized assessment of resource use in fast-track cardiac surgery 1-Year after hospital discharge. Anesthesiology 2003; Mar; 98(3); 651.

Collop NA, Kim S, Sahn SA: Analysis of tube thoracostomy performed by pulmonologists at a teaching hospital. Chest 1997;112(3):709-713.

Consorta: Best Practice Models, Implementing CABG Best Practices. 2001.

Cox JE: Transthoracic needle aspiration biopsy: variables that affect risk of pneumothorax. Radiology 1999;212(1):165-168.

Crawford BK, Galloway AC, et al: Treatment of AIDS-related bronchopleural fistula by pleurectomy. Annals of Thoracic Surgery 1992;54:212-215.

Crocker HL, Ruffin RE: Patient-induced complications of a Heimlich flutter valve. Chest 1998;113(3), 838-839.

Cunnington J: Spontaneous pneumothorax. Clinical Evidence 2003;10:1738-1746.

Daganou M, Dimopoulou I, Michalopoulos N, et al.: Respiratory complications after coronary artery bypass surgery with unilateral or bilateral internal mammary artery grafting. Chest 1998;113(5):1285-1289.

Davies CWH, Gleeson FV, Davies RJO: BTS guidelines for the management of pleural infection. Thorax 2003;58(Suppl II):ii18-ii28.

Drazen JM, Epstein AM. Guidance concerning surgery for emphysema. Editorial. NEJM 2003;348:2134-2136.

Fox V, Gould D, Davies N, Owen S: Patients’ experiences of having an underwater seal chest drain: a replication study. Journal of Clinical Nursing 1999;8:684-692.

Gift AG, Bolgiano CS, Cunningham J: Sensations during chest tube removal. Heart & Lung 1991;20(2):131-137.

Golden P: Follow up chest radiographs after traumatic pneumothorax or hemothorax in the outpatient setting: a retrospective review. International Journal of Trauma Nursing 1999;5(3):88 94.

Gordon P, Norton JM: Managing chest tubes: what is based on research and what is not? Dimensions of Critical Care Nursing 1995;14(1):14-16.

Gordon P, Norton JM, Merrel R: Refining chest tube management: analysis of the state of practice. Dimensions of Critical Care Nursing 1995;14(1):6-13.

Gordon PA, Norton JM, et al: Positioning of chest tubes: effects on pressure and drainage. American Journal of Critical Care 1997;6(1):33-38.

Gray DT, Veenstra DL: Comparative economic analyses of minimally invasive direct coronary artery bypass surgery. Journal of Thoracic and Cardiovascular Surgery 2003;125:618-624.

Hagl C, Harringer W, Gohrbandt B, Haverich A: Site of pleural drain insertion and early postoperative pulmonary function following coronary artery bypass grafting with internal mammary artery. Chest 1999;115(3):757-761.

Hayes DD: Stemming the tide of pleural effusions. Nursing Management 2001;32(12):30-34.

Heimlich HJ: Heimlich valve for chest drainage. Medical Instrumentation 1983;17(1):29-31.

Heimlich HJ: Valve drainage of the pleural cavity. Diseases of the Chest 1968;53(3):282-287.

Hicks D, Moreno S: Pneumothorax Care Plan Map. Tucson Medical Center. Tucson, AZ 1994. Available through CINAHL.

Henry M, Arnold T, Harvey J: BTS guidelines for the management of spontaneous pneumothorax. Thorax 2003;58(Suppl II):ii39-ii52.

Houston S, Jesurum J: The quick relaxation technique: effect on pain associated with chest tube removal. Applied Nursing Research 1999;12(4):196 205.

Hyde J, Sykes T, Graham T: Reducing morbidity from chest drains [editorial]. British Medical Journal 1997;314:914.

Irwin JP, O-Yurvati A, Peska D: Rapid ambulation post-thoracotomy with the Atrium Express Mini-500 system. Available online at: http://www.atriummed.com/PDF/RapidAmbulation.pdf

Jones PM, Hewer RD, Wofenden HD, Thomas PS: Subcutaneous emphysema associated with chest tube drainage. Respirology 2001;6:87-89.

Kam AC, O’Brien M, Kam PCA: Pleural drainage systems. Anaesthesia 1993;48:154-161.

Kinney MR, Kirchhoff KT, Puntillo KA: Chest tube removal practices in critical care units in the United States. American Journal of Critical Care 1995;4(6):419-424.

Kirby TJ, Ginsberg RJ: Management of pneumothorax and barotrauma. Clinics in Chest Medicine 1992;13(1):97-112.

Kirkwood P: Ask the experts: chest tube care and transport. Critical Care Nurse 2002;22(4):70-72.

Kirkwood P: Ask the experts: removing chest tubes and suction bubbling. Critical Care Nurse 2000;20(3):97-98.

Ko JP: Factors influencing pneumothorax rate at lung biopsy: are dwell time and angle of pleural puncture contributing factors? Radiology 2001; 218(2), 491-496.

Krishnan JA: High-frequency ventilation for acute lung injury and ARDS. Chest 2000;118(3):795-807.

Lazar HL, Fitzgerald CA, Ahmad T, Bao Y, Colton T, Shapira OM, et al.: Early discharge after coronary artery bypass graft surgery: are patients really going home earlier? Journal of Thoracic and Cardiovascular Surgery 2001;121(5):943-950.

Laws D, Neville E, Duffy K: BTS guidelines for the insertion of a chest drain. Thorax 2003;58(Suppl II):ii53-ii59.

Leavitt BJ, O’Connor GT, Olmstead EM, et al.: Use of the internal mammary artery graft and in-hospital mortality and other adverse outcomes associated with coronary artery bypass surgery. Circulation 2001;103:507-512.

Leonard M: A 21-year-old man with pneumothorax, subcutaneous emphysema, and a persistent air leak after chest tube insertion. Journal of Emergency Nursing 2003;29:5:425-426.

Light RW: Pneumothorax in the ICU: who is at risk and what can be done. Journal of Critical Illness 1997;12(2):77 80,83 84.

Luchette FA, Barrie PS, Oswanski MF et al.: Practice management guidelines for prophylactic antibiotic use in tube thoracostomy for traumatic hemopneumothorax: the EAST practice management guidelines work group. Journal of Trauma, Injury, Infection & Critical Care 2000;48(4):753-757.

Marshall MB, Deeb ME et al: Suction vs water seal after pulmonary resection: a randomized prospective study. Chest 2002;121(3):831-835.

Martino K, Merrit S, Boyakye K et al.: Prospective randomized trial of thoracostomy removal algorithms including commentary with author response. Journal of Trauma, Injury, Infection and Critical Care 1999;46(3):369 373.

Maskell NA, Butland RJA: BTS guidelines for the investigation of a unilateral pleural effusion in adults. Thorax 2003;58(Suppl II):ii8-ii17.

McKenna RJ, Fischel RJ, Brenner M, Gelb A: Use of the Heimlich valve to shorten hospital stay after lung reduction surgery for emphysema. Annals of Thoracic Surgery 1996;61:1115-1117.

Mimnaugh L, Winegar M, Mabrey Y, Davis, JE: Sensations experienced during removal of tubes in postoperative patients. Applied Nursing Research 1999;12(2):78 85.

Munnell ER: Thoracic drainage. Annals of Thoracic Surgery 1997;63:1497-1502.
National Cancer Institute: Malignant pleural effusion. 1998. Available online at: http://www.meds.com/pdq/effusion_pro.html

National Emphysema Treatment Trial Research Group. A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema. NEJM 2003;348:2059-2073.

National Emphysema Treatment Trial Research Group. Cost effectiveness of lung-volume-reduction surgery for patients with severe emphysema. NEJM; 2003;348:2092-2102.

National Emphysema Treatment Trial Research Group. Rationale and design of the National Emphysema Treatment Trial: a prospective randomized trial of lung volume reduction surgery. Chest 1999;116:1750-1761.

Obney J, Barnes MJ, Lisagor PG, Cohen DJ: Is bigger better for draining the mediastinum and thorax? [abstract] Chest 2000;118(4):116S.

Owen S, Gould D: Underwater seal chest drains: the patient’s perspective. Journal of Clinical Nursing 1997;6(3):215-225.

Pacanowski JP, Waack ML, Daley BJ: Is routine roentgenography needed after closed tube thoracostomy removal? Journal of Trauma, Injury, Infection & Critical Care 2000;48(4):684-688.

Powner DJ: A review of “chest tubes” during donor care and after transplantation. Progress in Transplantation 2002;12:61-67.

Powner DJ, Cline CD, Rodman GH: Effect of chest-tube suction on gas flow through a bronchopleural fistula. Critical Care Medicine 1985;13(2):99-101. [classic for discussion of physics]

Proehl JA: One-way valve. In: JA Proehl (Ed.), Emergency nursing procedures. WB Saunders Company Philadelphia 1999. pp.137-139.

Puntillo K: Analgesics and chest tube removal pain. American Journal of Critical Care 1994;3(3):245.

Puntillo KA: Effects of interpleural bupivicaine on pleural chest tube removal pain: a randomized, controlled trial. American Journal of Critical Care 1996;5(2):102-108.

Puskas JD, Williams WH, Duke PG, et al. Off pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury, transfusion requirements, and length of stay: A prospective, randomized comparison of two hundred unselected patients undergoing off-pump versus conventional coronary artery bypass grafting. Journal of Thoracic and Cardiovascular Surgery 2003;125:797-808.
Putnam, JB: Malignant pleural effusions. Surgical Clinics of North America 2002;82(4):867.

Rogers WB, Rogers RM: Understanding LVRS. RT The Journal for Respiratory Care Practitioners 1997;10(2):28,30,32,33,93.

Roman M, Weinstein A, Macaluso S: Primary spontaneous pneumothorax. MedSurg Nursing 2003;12(3):161-16.

Rusch VW, Capps JS, Tyler ML, Pierson DL: The performance of four pleural drainage systems in an animal model of bronchopleural fistula. Chest 1988;93:859-863. [classic for discussion of physics]

Russo L, Wiechmann RJ, Magovern JA et al.: Early chest tube removal after video-assisted thoracoscopic wedge resection of the lung. Annals of Thoracic Surgery 1998;66:1751-1754

Sahn SA: Malignant pleural effusions. Seminars in Respiratory and Critical Care Medicine 2001;22(6):607-615.

Saji H, Nakamura H, Tsuchida T et al.: The incidence and the risk of pneumothorax and chest tube placement after percutaneous CT-guided lung biopsy. Chest 2002;121(5):1521-1526.

Sandrick K: Fast tracking surgical management improves patient outcomes and reduced hospital length of stay. American College of Surgeons 1999. Available online at: http://www.meds.com/conrad/acs/fasttrack.html

Schlenker, EH: Cardiopulmonary anatomy and physiology. In: Hess, DR, MacIntyre, NR, Mishoe, SC, Galvin, WF, Adams, AB, Saposnick, AB (Eds.), Respiratory care principles and practice. WB Saunders Company Philadelphia 2002. pp.284.

Schmelz JO, Johnson D, Norton JM, Andrews M, Gordon PA: Effects of position of chest drainage tube on volume drained and pressure. American Journal of Critical Care 1999;8(5):319 323.

Schmidt U, Stalp M, Gerich T et al.: Chest tube decompression of blunt chest injuries by physicians in the field: effectiveness and complications. Journal of Trauma, Injury, Infection & Critical Care 1998;44(1):98-100.

Scholz JA: Nursing practice issues and answers. Issue: may a registered nurse remove a chest tube? Ohio Nurses Review 1997;72(4):16.

Scott F: Lung volume reduction surgery. Advance for Managers of Respiratory Care 1996;5(6):36-40.

Sittig SE: Ventilation for life. AARCTimes 2002;26(1):18,20-21.

Tang A, Hooper T, Hasan R: A regional survey of chest drains: evidence-based practice. Postgraduate Medical Journal 1999;75:471-474.

Tang ATM, Velissaris TJ, Weeden DF: An evidence-based approach to drainage of the pleural cavity: evaluation of best practice. Journal of Evaluation in Clinical Practice 2002;8(3):333-340.

Tattersall DJ, Traill ZC, Gleeson FV: Chest drains: does size matter? Clinical Radiology 2000;55:415-421.

Thompson SC, Wells S, Maxwell M: Chest tube removal after cardiac surgery. Critical Care Nurse 1997;17(1):34-38.

University of Arkansas for Medical Sciences Medical Center: Procedure for proper usage of the Heimlich valve 1996. Available at: http://www.uams.edu/nursingmanual/Procedures/procedure48.htm (Authorized students only)

Urschel JD, Parrott JCW, et al: Pneumothorax complicating cardiac surgery. Journal of Cardiovascular Surgery 1992;33:492-495.

Vricella LA, Trachiotis GD: Heimlich valve in the management of pneumothorax in patients with advanced AIDS. Chest 2001;120(1):15-18.

Ware JH: The national emphysema treatment trial – how strong is the evidence? NEJM 2003;348:2055-2056.

Weissberg D: Pneumothorax: Experience with 1,199 patients. Chest 2000;117:1279-1285.

Yamagami T, Nakamura T, Iida S, Kate T, Nishimura T: Management of pneumothorax after percutaneous CT-guided lung biopsy. Chest 2002:121:1159-1164.

Suggested Readings About Chest Tube Stripping

Duncan C, Erickson R: Pressures associated with chest tube stripping. Heart & Lung 1992;11(2):166-171.

Duncan CR, Erickson RS, Weigel RM: Effect of chest tube management on drainage after cardiac surgery. Heart & Lung 1987;16(1):1-9.

Gordon P, Norton JM, Merrel R: Refining chest tube management: analysis of the state of practice. Dimensions of Critical Care Nursing 1995;14(1):6-13.

Gordon P, Norton JM: Managing chest tubes: what is based on research and what is not? Dimensions of Critical Care Nursing 1995;14(1):14-16.

Gross, SB: Current challenges, concepts and controversies in chest tube management. AACN Clinical Issues in Critical Care 1993;4(2):260-275.

Isaacson JJ, George LT, Brewer MJ: The effect of chest tube manipulation on mediastinal drainage. Heart & Lung 1986;15(6):601-605.

Lim-Levy F, Babler SA, DeGroot-Kosolcharoen J et al.: Is milking and stripping chest tubes really necessary? Annals of Thoracic Surgery 1986;42(1):77-80.

Oakes LL, Hinds P, Rao B et al.: Chest tube stripping in pediatric oncology patients: an experimental study. American Journal of Critical Care 1993;2(4):293-301.

Pierce JD, Naftel DC: Effects of two chest tube clearance protocols on drainage in patients after myocardial revascularization surgery. Heart & Lung 1991;20(2):125-130.

Teplitz L: Update: Are milking and stripping chest tubes really necessary? Focus on Critical Care 1991;18(6):506-511.