The application of capnography to differentiate peri-chest tube air leak from parenchymal leak following pulmonary surgery

Prolonged air leak is a common complication of pulmonary resection. However, while a bubbling chest drain is commonly related to parenchymal air leakage, it may also be caused by air entering the pleural cavity via an incomplete seal of the tissues at the chest tube insertion site. Examination alone is not sufficient to guide the surgeon as to which of the above complications is responsible for drain bubbling. We describe a simple method, whereby a CO2 monitoring device is attached to the chest drain to determine whether the air loss observed is in fact due to a pulmonary air leak.