RT Journal Article SR Electronic T1 Impact and Predictors of Prolonged Chest Tube Duration in Mechanically Ventilated Patients with Acquired Pneumothorax JF Respiratory Care FD American Association for Respiratory Care SP 2093 OP 2100 DO 10.4187/respcare.02273 VO 58 IS 12 A1 Jiann-Hwa Kao A1 Hsin-Kuo Kao A1 Yen-Wen Chen A1 Wen-Kuang Yu A1 Sheng-Wei Pan A1 Jia-Horng Wang A1 Te-Cheng Lien A1 Li-Ing Ho A1 Yu Ru Kou YR 2013 UL http://rc.rcjournal.com/content/58/12/2093.abstract AB BACKGROUND: Prolonged chest tube duration is less well studied in patients who are supported by mechanical ventilation and have acquired pneumothorax. We investigated the impact of prolonged chest tube duration on patient outcomes and the risk factors associated with prolonged chest tube duration. METHODS: This retrospective observational study included 106 ventilated subjects who had been treated with thoracostomy for pneumothorax between May 2004 and December 2011. We analyzed 61 subjects and 63 events. The subjects were divided into a prolonged chest tube duration group (> 18 d) and a non-prolonged group (≤ 18 d). RESULTS: Subjects with prolonged chest tube duration had significantly higher ICU mortality (P = .006), longer ICU stay (P = .001), longer hospitalization (P = .004), longer mechanical ventilation after development of pneumothorax (P = .003), higher maximum peak inspiratory pressure (P = .03), and a higher rate of surgical emphysema (P = .009). High peak inspiratory pressure and surgical emphysema remained independent predictors of prolonged chest tube duration after multivariate logistic regression analysis. The probability of chest tube removal within 28 days was significantly lower in subjects with both high peak inspiratory pressure and surgical emphysema, compared to subjects without any risk factors (log rank P = .001). CONCLUSIONS: High peak inspiratory pressure and surgical emphysema are independent predictors of prolonged chest tube duration and negatively impact clinical outcomes in this patient group. These findings may provide information for better chest tube management.