Care with the thoracic drainage system in adults at the Universitary Hospital of Maringa, Parana State, Brazil/Cuidados com o sistema de drenagem toracica em adultos internados no hospital Universitario regional de Maringa, estado do Parana, Brasil

The handling of adults' closed thoracic drainage systems at the University Hospital of Maringa, Maringa, Parana State, Brazil during a 10-month period was prospectively evaluated. Ninety thoracic drainages in 75 patients were analyzed. Traumatic causes in young patients determined pleural drainage (61/90, 68%). The absence of an omental tag of tape as a complementary tube fixation was the most common, albeit isolated case, occurrence in the procedure. In fact, it has been routinely found in 20% (18/90) of cases. Whereas tube obstruction (due to kinking, siphoning, clotting or fibrin) was detected in 12% (11/90) of drainage cases, drainage complications (subcutaneous emphysema, infection, accidental dislodgement, pneumothorax following chest tube removal) occurred in 21% (20/90) of cases. Adequate handling of tube thoracostomy reduces morbidity related to this procedure. Current research enhances the importance of continuous training and of textbooks that would standardize procedures for health teams whose role involves interventions in the thoracic drainage system. Keywords: drainage, chest tubes, thoracostomy, pleural cavity, thoracic surgery. Avaliou-se, prospectivamente, o manejo dos sistemas de drenagem toracica fechada em pacientes adultos no Hospital Universitario de Maringa, Estado do Parana, no periodo de dez meses. Foram acompanhadas 90 drenagens em 75 pacientes. Predominou a causa traumatica em pacientes jovens como determinante de indicacao da drenagem pleural (61/90, 68%). A falta do curativo em meso e contrameso, como fixacao complementar do dreno, foi a ocorrencia isolada mais comum no manejo, sendo encontrado rotineiramente em 20% (18/90). A presenca de obstrucao (por dobramento, sifonagem, coagulo ou fibrina) esteve presente em 12% das drenagens (11/90) e complicacoes (enfisema subcutaneo, infeccao, deslocamento acidental, pneumotorax na retirada do dreno) em 21% (20/90). O manejo apropriado da drenagem toracica reduz a morbidade associada ao metodo. Esta pesquisa ressalta a importancia do treinamento continuado e do estabelecimento de manuais que padronizem condutas para os profissionais da saude que manejam o sistema de drenagem toracica. Palavras-chave: drenagem, tubos toracicos, toracostomia, cavidade pleural, cirurgia toracica.