O-020
RECURRENT AIR LEAK EARLY AFTER PULMONARY LOBECTOMY: AN ANALYSIS BASED ON AN ELECTRONIC AIRFLOW EVALUATION

Objectives: The objective of this analysis was to evaluate the incidence and risk factors of recurrent air leak (RAL) occurring early after pulmonary lobectomy based on electronic airflow measurements.

Methods: This is a prospective observational analysis on 129 consecutive patients managed with a single chest tube connected with an electronic chest drainage system. The incidence and timing of RAL among patients who had an air leak sealed within the first 24 postoperative hours was recorded. Stepwise logistic regression and bootstrap analyses were used to test the association of several baseline and surgical variables with RAL.

Results: Ninety-five patients (68%) had their air leak stopped within 24 hours after the operation. Twelve patients had RAL (13%) after the first stop. Average time from the initial stop to the first recurrence was 6.3 hours. All recurrent air leaks occurred within the first 24 hours from operation. The average duration of air leak of patients with RAL was 4 days. Logistic regression showed that the presence of moderate to severe COPD (FEV1 < 80% and FEV1/FVC ratio <0.7) was the only independent risk factor associated with RAL (P = 0.02, bootstrap frequency 83%). Age, sex, DLCO, BMI, side and site of resection and level of regulated suction were not associated with occurrence of RAL. Seven of 27 (26%) patients with COPD had RAL, a proportion significantly higher than in patients without COPD (5 of 68, 7.3%, P = 0.03).

Conclusions: A large proportion of patients with COPD developed RAL. In this high-risk group, we advise against chest tube removal in the first 24 hours after operation even in case of absence or cessation of the air leak.

Disclosure: I. Cregan: Research coordinator and employee of Medela Helthcare.