METHODS: We looked for papers comparing the withdrawal of the thoracostomy tube during the last stages of expiration and inspiration for the management of thoracic injuries on Embase, Pubmed, Cochrane Library and Google Scholar. Review Manager was used to determine mean differences (MD) and risk ratios (RR) using a 95% confidence interval (CI).
RESULTS: The primary outcomes showed no significant difference between the inspiration and expiration groups: recurrent pneumothorax (RR 1.27, 95% CI 0.83-1.93, P 0.28) and thoracostomy tube reinsertion (OR: 1.84, CI 0.50-6.86, P 0.36, I2 5%). However, the duration of hospital stay was significantly lower in patients in whom the thoracostomy tube was removed at the end of inspiration (RR 1.8, 95% CI 1.49-2.11, P < 0.00001, I2 0%). The implications of these findings warrant cautious interpretation, accounting for potential confounding factors and inherent limitations that may shape their significance.
CONCLUSIONS: The thoracostomy tube can be removed during both the end-expiratory and end-inspiratory stages of respiration with no appreciable difference. Nevertheless, caution should be exercised when ascertaining the implications of these findings, taking into account the potential limitations and confounding variables that may exert influence upon the outcomes.
方法:我们寻找比较在呼气的最后阶段和灵感的文献,以治疗Embase上的胸部损伤,Pubmed,科克伦图书馆和谷歌学者。使用ReviewManager以95%置信区间(CI)确定平均差异(MD)和风险比(RR)。
结果:主要结果显示吸气组和呼气组之间没有显着差异:复发性气胸(RR1.27,95%CI0.83-1.93,P0.28)和胸廓造口管再插入(OR:1.84,CI0.50-6.86,P0.36,I25%)。然而,在吸气结束时拔除胸廓造口管的患者的住院时间明显较短(RR1.8,95%CI1.49-2.11,P<0.00001,I20%).这些发现的含义值得谨慎解释,考虑可能影响其重要性的潜在混杂因素和固有限制。
结论:在呼气末和吸气末呼吸阶段均可取出胸廓造口管,但无明显差异。然而,在确定这些发现的含义时应谨慎行事,考虑到可能对结果产生影响的潜在限制和混杂变量。