F-069 * DIGITAL PLEURAL DRAINAGE DEVICES ARE NOT NEEDED TO PREDICT THE OCCURRENCE OF PROLONGED AIR LEAK

Objectives: One of the reported advantages of digital pleural drainage devices is the possibility of predicting the occurrence of prolonged air leak (PAL) based on the recorded pleural pressures and/or air flow through chest tubes. Nevertheless, this fact has never been well supported. The objective of this investigation is to evaluate if the occurrence of PAL can accurately be predicted using clinical data and air leak measurements 24 hours after lung resection on conventional drainage systems. Methods: Prospective observational study on 100 consecutive non-complicated patients who underwent anatomical lung resection (segmentectomy, lobectomy or bilobectomy). Prior to the operation, the risk of PAL was evaluated according to the score previously published (Ann Thorac Surg 2010;90:204). 24 hours after surgery, two independent observers measured air flow at forced deep expiration on a conventional drainage system with graduated analogical leak monitor. The agreement between both observers was calculated and in cases of discrepancy, the mean of both observations was calculated. After discharge, the occurrence of PAL (defined as persistent air leak 5 or more days after the operation) was recorded. A logistic regression model was constructed including two independent continuous variables (PAL score and air flow) and the performance of the model was assessed by non-parametric ROC curves. Results: The series includes 80 lobectomies, 8 bilobectomies and 11 anatomical segmentectomies. Median preoperative PAL score was 1 (range 0-3.5). Any postoperative air flow was observed in 30 cases with a median value of 1 (0.5-3.5). The prevalence of PAL in the series was 10% (10 out of 100 cases). Both independent variables entered in the model (PAL score P = 0.050, air flow: 0.016) and C-index was 0.83. Conclusions: The performance of this simple predictive model, without any electronic recording, is very good, allowing early clinical decision-making on patients with air leak after lung resection. Disclosure: No significant relationships.