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Extubate or remove chest drain - which first?

PNMX
in Respiratory Disorders

Extubate or remove chest drain - which first? 33 members have voted

  1. 1. Preterm, severe RDS, ventilated, tension pneumothorax resolved with chest drain, no reaccumulation for >24 hours, low MAP. Which you would do first

    • Extubate
      13
    • Remove chest drain
      20

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Featured Replies

Preterm, severe RDS, ventilated, tension pneumothorax resolved with chest drain, no reaccumulation for >24 hours, low MAP, FiO2 25%, off iNO. Which you would do first - extubate or remove chest drain?

    • Upvote 1

    Chest drain is very painful. Opioids are no problem on a ventilated baby. And before Cpap we want to be sure that there no second pneumothorax occurrs.

    So I would remove chest drain first

    •
    • Like 2
    • Upvote 1

    After clamping there is no reaccumulation of air, removal of chest tube should be first followed by extubation. It’s my opinion

    • Like 1

    Would extubate first. Reason being that preterm baby after extubation usually requires CPAP/ NIPPV/HHFNC which do carry some risk of pneumothorax.

    •
    • Like 1

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    https://99nicu.org/forums/topic/2859-extubate-or-remove-chest-drain-which-first/
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