Digital and smart chest drainage systems to monitor air leaks: the birth of a new era?
Robert J Cerfolio, Gonzalo Varela, Alessandro Brunelli
https://pubmed.ncbi.nlm.nih.gov/20619233/Actively Recruiting
Led by University of Oklahoma · Updated on 2026-04-01
140
Participants Needed
1
Research Sites
34 weeks
Total Duration
Researchers are investigating the use of digital versus analog chest tube drainage systems in pediatric patients aged 17 years and younger who require chest tubes due to spontaneous pneumothorax or pulmonary resection. The study addresses a gap in pediatric research, as only two prior studies have explored digital drainage in children, and none have prospectively compared digital and analog systems. The adult literature suggests digital systems may reduce chest tube duration, length of hospital stay, chest x-rays, and costs, which this trial aims to evaluate in children. This prospective randomized controlled trial takes place at a single site and enrolls pediatric patients who will be randomly assigned to either the Thopaz digital drainage system or the traditional analog Pleur-evac system. Randomization is stratified by surgery type pulmonary resection or spontaneous pneumothorax using sealed envelopes. The study is unblinded, and the digital system uses sensors to measure air leaks and maintain constant pleural pressure, while the analog system uses a water chamber to detect air leaks based on visible bubbling. Participants will be followed during their hospital stay to record chest tube drainage duration, length of stay, time to first ambulation, number of chest x-rays, complications like pneumonia, and presence of air leaks defined by device-specific criteria. Data collection will continue until an adequate sample size is reached. Results will be analyzed to compare outcomes between the two groups, with the primary outcome focused on device performance over two years. Individual results will remain confidential, and de-identified data may be used for future research.
CONDITIONS
Digital Chest Tube Drainage System (Thopaz+) Versus Analog in Pediatric Patients
C
Catherine Hunter, MD
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University of Oklahoma
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Madela THOPAZ Digital Chest Drainage Device | Atrium Dry Suction Water Seal Analog Device | Current Use of Digital Drainage Systems in Pediatric Chest Tube Management |
|---|---|---|---|
| What is it? | A digital chest tube drainage device that uses electronic sensors to continuously monitor air leak, providing graphic and quantitative data in real time. | An analog water seal chest tube drainage device that uses numbered columns and bubbling observation to qualitatively assess air leaks at one point in time. | Published studies show digital chest drainage systems are increasingly used for continuous monitoring and quantification of air leaks in pediatric patients following chest tube placement. |
| Role in trial | Randomized investigational device arm; patients receive the Madela THOPAZ digital chest tube drainage system. | Active comparator device arm; patients receive the Atrium analog chest tube drainage system. | Used in routine practice as a modern alternative to analog drainage systems for pediatric chest tube management. |
| Primary use | Continuous quantitative monitoring and assessment of chest tube air leaks to guide removal and hospital discharge. | Qualitative air leak assessment during chest tube management based on visual observation of bubbling. | Continuous air leak monitoring and quantification to streamline chest tube removal and reduce length of stay. |
| How is it used? | Connected to chest tube immediately after surgical placement; measures air leak and intrapleural pressure continuously. | Connected to chest tube, bubbling observed in water seal columns periodically by healthcare staff. | Integrated into post-surgical chest tube management, recording air leak and pressure data for review. |
| Evidence status | On trial; results for pediatric air leak outcomes not yet posted, but digital systems are supported by growing observational evidence. | Longstanding standard device; used for qualitative air leak assessment. Evidence to support outcomes drawn from current practice and registry. | Published studies indicate digital systems streamline chest tube management, reduce hospital stay, and enable more objective air leak measurement in pediatric populations. |
| Important limitations | Device availability, technical training needs, and cost may limit use in some pediatric settings. Trial results for pediatric air leak are not yet available. | Qualitative assessment creates possibility for interobserver variability and less objective air leak monitoring. | Widespread adoption of digital systems may be restricted by higher cost, need for specialized staff training, and lack of outcome data from large randomized pediatric trials. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person) for consent and eligibility assessment
Duration - Duration of chest tube placement (days and hours) during inpatient stay
Participants undergo chest tube placement with either a digital or analog chest tube drainage system as part of their inpatient care.
Ongoing inpatient monitoring while chest tube is connected
Duration - Until chest tube removal and hospital discharge
Participants are followed during their inpatient stay to assess chest tube duration, length of hospital stay, time to first ambulation, progression to water seal, complications, and air leak presence.
Daily assessments during inpatient stay
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
DIAGNOSTIC
Number of Arms
2
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https://pubmed.ncbi.nlm.nih.gov/23024236/University of Oklahoma
Lead Sponsor