Cuidados de enfermagem ao paciente adulto com drenagem torácica: uma revisão de escopo

Silva, Elisiane Goveia da; Araujo, Bárbara Rodrigues; Borges, Raphaela de Matos; Vieira, Tainara Wink; Paula, Cristiane Cardoso de; Caregnato, Rita Catalina Aquino

doi:10.1590/1980-220X-REEUSP-2024-0017pt

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Brasil

Revista da Escola de Enfermagem da USP

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Sumário

REVISÃO • Rev. esc. enferm. USP 58 • 2024 • https://doi.org/10.1590/1980-220X-REEUSP-2024-0017pt copiar

Cuidados de enfermagem ao paciente adulto com drenagem torácica: uma revisão de escopo^* * Extraído da dissertação “Protocolo assistencial de enfermagem para pacientes submetidos a drenagem torácica”, Universidade Federal de Ciências da Saúde de Porto Alegre, 2023.

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivo:

Mapear os cuidados de enfermagem recomendados aos pacientes adultos submetidos à drenagem torácica.

Método:

Revisão de escopo. Incluíram-se estudos em português, inglês e espanhol, sem recorte temporal, que responderam à questão de pesquisa: quais são os cuidados de enfermagem indicados aos pacientes adultos com drenagem torácica internados em terapia intensiva? Seleção nas bases de dados MEDLINE/PubMed, Embase/Elsevier, Web of Science/Clarivate, Scopus/Elsevier, CINAHL/Ebsco e LILACS/BVS. Não foram incluídos dados de literatura cinzenta.

Resultados:

Dos 973 artigos identificados, selecionaram-se 21. Os cuidados mais citados incluíram: preencher frasco coletor com água destilada ou solução fisiológica deixando extremidade distal da haste submersa 1,5 a 2,5 centímetros; monitorização sinais vitais; manejo da dor; e posicionamento adequado do sistema. Observaram-se divergências na indicação de clampeamento do sistema e na ordenha do dreno/sistema de drenagem.

Conclusão:

Mapeados 60 cuidados de enfermagem, sendo 13 no momento pré-inserção do dreno, nove durante a inserção e 38 após a inserção do dreno de tórax.

DESCRITORES
Cuidados de Enfermagem; Tubos Torácicos; Unidades de Terapia Intensiva

Base de dados	Estratégia
MEDLINE/PubMed	(Nursing Care[mh:noexp] OR Nursing[mh] OR Nursing, Team[mh] OR Nursing Staff, Hospital[mh] OR Nursing Service, Hospital[mh] OR Nursing Assessment[mh] OR Nursing Process[mh:noexp] OR Nurses[mh] OR Nursing[sh] OR Nursing[tiab] OR Nurse[tiab]) AND (Thoracostomy[mh] OR Thoracostom[tiab] OR Thoracic drain[tiab] OR Thorax drain[tiab] OR Chest drain[tiab] OR Pleural drain[tiab] OR ((Chest Tubes[mh] OR Chest Tube[tiab]) AND (Drainage[mh] OR Drain[tiab] OR Suction[mh] OR Suction[tiab])))
Embase/Elsevier	(‘nursing care’/exp OR ‘nursing’/exp OR ‘nursing staff’/exp OR ‘nurse’/exp OR Nursing:ti,ab,kw OR Nurse:ti,ab,kw) AND (‘thoracostomy’/exp OR ‘thorax drainage’/exp OR Thoracostom:ti,ab,kw OR ‘Thoracic drain’:ti,ab,kw OR ‘Thorax drain’:ti,ab,kw OR ‘Chest drain’:ti,ab,kw OR ‘Pleural drain’:ti,ab,kw OR ((‘chest tube’/exp OR ‘Chest Tube’:ti,ab,kw) AND (‘suction drain’/exp OR ‘drain’/de OR ‘suction’/de OR ‘suction drainage’/de OR Drain:ti,ab,kw OR Suction:ti,ab,kw))) AND ([embase]/lim NOT ([embase]/lim AND [medline]/lim))
Web of Science	TS=(Nursing OR Nurse) AND TS=(Thoracostom OR “Thoracic drain” OR “Thorax drain” OR “Chest drain” OR “Pleural drain”) OR (TS=”Chest Tube” AND TS=(Drain OR Suction))
Scopus	TITLE-ABS-KEY(Nursing OR Nurse) AND (TITLE-ABS-KEY(Thoracostom OR “Thoracic drain” OR “Thorax drain” OR “Chest drain” OR “Pleural drain”) OR (TITLE-ABS-KEY(“Chest Tube”) AND TITLE-ABS-KEY(Drain OR Suction)))
CINAHL	(MH (“Nursing Care” OR Nursing OR “Nursing, Team” OR “Nursing Staff, Hospital” OR “Nursing Service, Hospital” OR “Nursing Assessment” OR “Nursing Process” OR “Nurses”) OR TI (Nursing* OR Nurse) OR AB (Nursing OR Nurse) OR SU (Nursing OR Nurse)) AND* (((MH Chest Tubes OR TI “Chest Tube” OR AB “Chest Tube” OR SU “Chest Tube”) AND (MH (Drainage OR Suction) OR TI (Drain OR Suction) OR AB (Drain OR Suction) OR SU (Drain OR Suction))) OR MH thoracostomy OR TI (Thoracostom OR “Thoracic drain” OR “Thorax drain” OR “Chest drain” OR “Pleural drain”) OR AB (Thoracostom* OR “Thoracic drain” OR “Thorax drain” OR “Chest drain” OR “Pleural drain”) OR SU (Thoracostom* OR “Thoracic drain” OR “Thorax drain” OR “Chest drain” OR “Pleural drain”)))
BVS	(mh:(“Nursing Care” OR Nursing OR “Nursing, Team” OR “Nursing Staff, Hospital” OR “Nursing Service, Hospital” OR “Nursing Assessment” OR “Nursing Process” OR N02.360.650) OR ti:(Enfermage OR Nursing* OR Enfermeria* OR Enfermera* OR Enfermero* OR Enfermeir) OR ab:(Enfermage OR Nursing* OR Enfermeria* OR Enfermera* OR Enfermero* OR Enfermeir)) AND* (mh:(“Chest Tubes” OR Thoracostomy) OR ti:(“Chest Tubes” OR “Chest Tube” OR “Tubos toracicos” OR “Tubo toracico” OR Thoracostom* OR Toracostom) OR ab:(Thoracostom OR Toracostom) OR (tw:(Thorax OR Thoracic* OR Torax OR Toracic* OR Pleura* OR Chest) AND (tw:Drenage OR Drenaje* OR Dreno* OR Drain* OR Suction* OR Succao OR Succoes OR Succion*)))

Código	Título do Estudo	Ano	País de Ori-gem	Objetivo do Estudo	Desenho	População
E1	Nursing management of chest drains: a systematic review(²¹21. Charnock Y, Evans D. Nursing management of chest drains: a systematic review. Aust Crit Care. 2001;14(4):156–60. doi: http://doi.org/10.1016/S1036-7314(05)80058-X.PubMed PMID: 11806513. https://doi.org/10.1016/S1036-7314(05)80... )	2001	Austrá-lia	Apresentar a melhor evidência de pesquisa disponível sobre o manejo de enfermagem de drenos torácicos.	Revisão sistemática	Oito ensaios controlados randomizados.
E2	Retirada de dreno torácico em pós-operatório de cirurgia cardíaca(²²22. Parra AV, Amorim RC, Wigman SE, Baccaria LM. Withdrawal of thorax drain in postoperative of cardiac surgery. Arq Ciênc Saúde [Internet]. 2005 [cited 2023 Nov 21];12(2):116–119. Available from: https://repositorio-racs.famerp.br/racs_ol/Vol-12-2/10.pdf. https://repositorio-racs.famerp.br/racs_... )	2005	Brasil	Elaborar um roteiro para retirada de dreno torácico por enfermeiros em unidade coronariana e cirurgia cardíaca.	Revisão bibliográfica	Não consta número total de estudos incluídos.
E3	To strip or not to strip? Physiological effects of chest tube manipulation(²³23. Halm MA. To strip or not to strip? Physiological effects of chest tube manipulation. Am J Crit Care. 2007;16(6):609–12. doi: http://doi.org/10.4037/ajcc2007.16.6.609.PubMed PMID: 17962505. https://doi.org/10.4037/ajcc2007.16.6.60... )	2007	Estados Unidos	Resumir as evidências científicas em relação a ordenha dos drenos torácicos.	Revisão de literature	Cinco estudos de pesquisa originais, uma revisão sistemática, dois estudos descritivos exploratórios.
E4	Nursing management of patients with a chest drain(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... )	2008	Reino Unido	Examinar o papel da enfermagem no gerenciamento da drenagem torácica, desde a inserção até a remoção, e incluir aspectos do controle da dor características de um dreno torácico funcional.	Revisão de literature	Entre 2000-2007, 15 artigos; porém, os autores aumentaram o período para 1995-2007 e não informaram total de artigos.
E5	A influência do uso do “clamp” ou braçadeira no acúmulo de coágulos em drenos pleurais tubulares(²⁵25. Lima AG, Rocha ERF, Seabra JCT, et al. The influence of clamp usage on clot deposit formation inside thoracic drains. Rev Col Bras Cir. 2008;35(2):79–82. doi: http://doi.org/10.1590/S0100-69912008000200003. https://doi.org/10.1590/S0100-6991200800... )	2008	Brasil	Avaliar a influência do uso da braçadeira sobre o acúmulo de coágulos dentro dos drenos pleurais.	Estudo de campo prospectivo	53 pacientes (53 drenos pleurais).
E6	The Effect of Cold Application in Combination with Standard Analgesic Administration on Pain and Anxiety during Chest Tube Removal: A Single-Blinded, Randomized, Double-Controlled Study(²⁶26. Demir Y, Kborsbid L. The effect of cold application in combination with standard analgesic administration on pain and anxiety during chest tube removal: a single-blinded, randomized, double-controlled study. Pain Manag Nurs. 2010;11(3):186–96. doi: http://doi.org/10.1016/j.pmn.2009.09.002.PubMed PMID: 20728068. https://doi.org/10.1016/j.pmn.2009.09.00... )	2010	Turquia	Investigar o efeito da aplicação de frio na dor e ansiedade durante a remoção do dreno torácico no paciente submetido a cirurgia cardíaca.	Estudo randomizado simples-cego	90 pacientes internados na UTI cirúrgica cardiovascular e torácica.
E7	Assistência de enfermagem na drenagem torácica: revisão de literatura(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... )	2011	Brasil	Realizar revisão de literatura sobre a assistência de enfermagem na drenagem torácica.	Revisão de literature	Não consta número total de estudos incluídos.
E8	Analytical Study on Practices Related to Care of Water Sealed Chest Drainage System(²⁸28. Rashmi TR. Analytical Study on Practices Related to Care of Water Sealed Chest Drainage System. Int J Nurs Stud. 2012 [cited 2023 Nov 21];4(2):177:182. Available from: https://ijone.org/scripts/IJONE%20JOURNAL.July-Dec%2012.pdf. https://ijone.org/scripts/IJONE%20JOURNA... )	2012	Índia	Analisar as práticas prevalentes no cuidado do sistema de drenagem torácica selado com água de acordo com as opiniões dos especialistas e contra as evidências disponíveis.	Estudo observacional	14 especialistas.
E9	Chest tube care in critically ill patient: A comprehensive review(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... )	2015	Egito	Conhecer riscos associados à inserção do dreno torácico. Descrever forma de preparo de unidade de drenagem torácica, realizar avaliações contínuas do paciente, documentar adequadamente e solucionar possíveis problemas relacionados ao uso de dreno torácico.	Revisão de literature	Não consta número total de estudos incluídos.
E10AD	Manipulação de drenos mediastinais e pleurais: existe evidência científica?(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... )	2015	Brasil	Verificar a existência de evidência científica na manipulação de drenos pleurais e mediastinais na cirurgia cardíaca.	Revisão sistemática	Seis artigos, sendo uma revisão, um ensaio clínico controlado, um estudo experimental controlado e dois estudos descritivos.
E11	Institutional protocol to standardize the chest drainage system management, from surgery to nursing care, at a regional hospital in northern Paraná(³¹31. Morais ACC, Lemos MM, Marques VD, Bandeira COP. Institutional protocol to standardize the chest drainage system management, from surgery to nursing care, at a regional hospital in northern Paraná. Acta Sci [Internet]. 2016;38(2):173–7. doi: http://doi.org/10.4025/actascihealthsci.v38i2.26972. https://doi.org/10.4025/actascihealthsci... )	2016	Brasil	Avaliar o manejo dos sistemas fechados de drenagem torácica por meio da análise de pacientes adultos do Hospital Universitário Regional de Maringá, Paraná, padronizar o protocolo de atendimento em drenagem torácica e minimizar complicações.	Estudo observacional prospectivo	Observadas 100 drenagens torácicas, de 83 pacientes.
E12AD	Nurses’ knowledge and Practice regard Care of Patient with Chest Drains in Sudan Heart Center, Khartoum, Sudan(³²32. Elfaki BA, Mustafa HE, Ahmed AH. Nurses’ knowledge and Practice regard Care of Patient with Chest Drains in Sudan Heart Center, Khartoum, Sudan. IOSR-JNHS. 2016 [cited 2023 Nov 21], 5(6):1–6. Available from: https://www.iosrjournals.org/iosr-jnhs/papers/vol5-issue6/Version-4/A0506040106.pdf. https://www.iosrjournals.org/iosr-jnhs/p... )	2016	Sudão	Avaliar o conhecimento e a prática do enfermeiro em relação ao paciente conectado à drenagem torácica.	Estudo quantitativo descritivo	50 enfermeiros.
E13	Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study(³³33. Lu C, Jin YH, Gao W, Shi YX, Xia X, Sun WX, et al. Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study. J Clin Nurs. 2018;27(5-6):1013–21. doi: http://doi.org/10.1111/jocn.14127.PubMed PMID: 29076204. https://doi.org/10.1111/jocn.14127... )	2018	China	Revelar a prática autorrelatada de gerenciamento de drenos torácicos por enfermeiras e definir os tomadores de decisão para essas práticas.	Estudo transversal	296 enfermeiros.
E14	Intervenção de enfermagem: cuidados com dreno torácico em adultos no pós-operatório(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... )	2018	Brasil	Validar as atividades de enfermagem para intervenção estabelecida pela Nursing Interventions Classification “cuidados com dreno torácico”.	Estudo de validação de conteúdo	30 enfermeiras especialistas.
E15	Comparative Evaluation of Chest Tube Insertion Site Dressings: A Randomized Controlled Trial(³⁵35. Wood MD, Powers J, Rechter JL. Comparative evaluation of chest tube insertion site dressings: a randomized controlled trial. Am J Crit Care. 2019;28(6):415–23. doi: http://doi.org/10.4037/ajcc2019645.PubMed PMID: 31676515. https://doi.org/10.4037/ajcc2019645... )	2019	Estados Unidos	Comparar vários tipos de curativos e procedimentos após a colocação de drenos torácicos e mediastinais.	Estudo prospectivo randomizado	127 pacientes, de três Unidades de Terapia Intensiva, e 236 drenos de tórax. Amostra três grupos, cada um com uma cobertura e frequência de troca diferentes.
E16	Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards(³⁶36. Gan KLJ, Tan M. Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards. Int J Evid-Based Healthc. 2015;13(2):58–65. doi: http://doi.org/10.1097/XEB.0000000000000041.PubMed PMID: 26057649. https://doi.org/10.1097/XEB.000000000000... )	2021	Estados Unidos	Implementar as melhores práticas para fornecer cuidados seguros e eficazes a pacientes com sistema de drenagem torácica em enfermarias cardiotorácicas.	Revisão de literature	Não consta número de estudos incluídos.
E17	Interdisciplinary teamwork for chest tube insertion and management: an integrative review(³⁷37. Ghazali DA, Ilha-Schuelter P, Barbosa SS, Truchot J, Ceccaldi P, Tourinho F, et al. Interdisciplinary teamwork for chest tube insertion and management: an integrative review. Anaesthesiol Intensive Ther. 2021;53(5):456–65. doi: http://doi.org/10.5114/ait.2021.111349.PubMed PMID: 34870385. https://doi.org/10.5114/ait.2021.111349... )	2021	França	Identificar os artigos relacionados ao manejo interdisciplinar da toracotomia.	Revisão integrative	19 artigos.
E18AD	Boas práticas de enfermagem na utilização de dreno de tórax: revisão integrativa(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... )	2021	Brasil	Identificar na literatura científica as melhores práticas de enfermagem relacionadas à utilização de dreno torácico em Unidade de Terapia Intensiva adulta.	Revisão integrative	Cinco artigos, sendo um quanti-qualitati-vo e quatro quantitativos.
E19AD	Chest drains: prevalence of insertion and ICU nurses’ knowledge of care(³⁸38. Seyma ZK, Meral YC, Atiye E. Nurses’ Knowledge Levels About the Care of the Patients with Chest Tube. Int J Caring Sci. 2021 [cited 2023 Nov 21];14(2):1334–42. Available from: https://www.internationaljournalofcaringsciences.org/docs/58_zeyrek_original_14_2.pdf. https://www.internationaljournalofcaring... )	2021	Jordâ-nia	Descrever a taxa de prevalência de inserção de dreno torácico nas UTIs jordanianas e avaliar o nível de conhecimento dos enfermeiros jordanianos sobre os cuidados com o dreno torácico.	Estudo descritivo não experimental com pesquisa transversal	1973 arquivos analisados e questionário com 225 enfermeiros.
E20AD	Nurses’ Knowledge Levels About the Care of the Patients with Chest Tube(³⁹39. Ghazali DA, Ilha-Schuelter P, Barreyre L, Stephan O, Barbosa SS, Oriot D, et al. Development and validation of the frst performance assessment scale for interdisciplinary chest tube insertion: a prospective multicenter study. Eur J Trauma Emerg Surg. 2022;48(5):4069–78. doi: http://doi.org/10.1007/s00068-022-01928-9.PubMed PMID: 35376968. https://doi.org/10.1007/s00068-022-01928... )	2021	Turquia	Determinar o nível de conhecimento dos enfermeiros sobre os cuidados aos pacientes com dreno torácico.	Estudo descritivo	152 enfermeiros.
E21	Development and validation of the first performance assessment scale for interdisciplinary chest tube insertion: a prospective multicenter study(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )	2022	Alema-nha	Validar uma escala interdisciplinar de avaliação de desempenho para inserção de dreno torácico desenvolvida a partir da análise da literatura.	Estudo multicêntrico prospectivo	40 vídeos de sessões de simulação realizadas por 80 participantes.

N°	Recomendações pré-inserção do DT	Código dos estudos
1	Verificar dupla identificação do paciente.	E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
2	Informar o paciente sobre o procedimento e como ele poderá ajudar.	E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E17(³⁷37. Ghazali DA, Ilha-Schuelter P, Barbosa SS, Truchot J, Ceccaldi P, Tourinho F, et al. Interdisciplinary teamwork for chest tube insertion and management: an integrative review. Anaesthesiol Intensive Ther. 2021;53(5):456–65. doi: http://doi.org/10.5114/ait.2021.111349.PubMed PMID: 34870385. https://doi.org/10.5114/ait.2021.111349... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
3	Orientar a família sobre o cuidado adequado.	E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... )
4	Aplicar Termo de Consentimento Informado.	E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E17(³⁷37. Ghazali DA, Ilha-Schuelter P, Barbosa SS, Truchot J, Ceccaldi P, Tourinho F, et al. Interdisciplinary teamwork for chest tube insertion and management: an integrative review. Anaesthesiol Intensive Ther. 2021;53(5):456–65. doi: http://doi.org/10.5114/ait.2021.111349.PubMed PMID: 34870385. https://doi.org/10.5114/ait.2021.111349... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
5	Verificar alergias.	E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
6	Preparar os materiais adequados para inserção do DT: solução antisséptica (sugere-se o uso de solução de clorexidine alcoólica pelo maior custo-benefício), avental, máscara e luvas estéreis, campos estéreis, bandeja para tubo torácico esterilizada, anestésico local, agulhas, seringas, bisturi com lâmina, pinças curvas kelly, dreno torácico, sistema de drenagem, lixo perfurocortante, material para o curativo.	E17(³⁷37. Ghazali DA, Ilha-Schuelter P, Barbosa SS, Truchot J, Ceccaldi P, Tourinho F, et al. Interdisciplinary teamwork for chest tube insertion and management: an integrative review. Anaesthesiol Intensive Ther. 2021;53(5):456–65. doi: http://doi.org/10.5114/ait.2021.111349.PubMed PMID: 34870385. https://doi.org/10.5114/ait.2021.111349... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
7	Higienização simples das mãos com antisséptico.	E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... )
8	Posicionar o paciente no leito confortavelmente: com o braço do lado onde o dreno será inserido, colocado atrás da cabeça de modo a expor a axila. O cirurgião poderá solicitar um travesseiro ou cobertor dobrado sob as omoplatas do paciente para elevar o tórax e facilitar o acesso.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
9	Preencher o frasco coletor com água destilada ou solução fisiológica deixando a extremidade distal da haste submersa de 1,5 a 2,5 centímetros.	E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E10AD(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... ), E11(³¹31. Morais ACC, Lemos MM, Marques VD, Bandeira COP. Institutional protocol to standardize the chest drainage system management, from surgery to nursing care, at a regional hospital in northern Paraná. Acta Sci [Internet]. 2016;38(2):173–7. doi: http://doi.org/10.4025/actascihealthsci.v38i2.26972. https://doi.org/10.4025/actascihealthsci... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
10	Preencher a câmara de controle de sucção com água até o nível de 20 centímetros de água (cmH2O).	E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... )
11	Administrar analgesia conforme prescrição médica.	E2(²²22. Parra AV, Amorim RC, Wigman SE, Baccaria LM. Withdrawal of thorax drain in postoperative of cardiac surgery. Arq Ciênc Saúde [Internet]. 2005 [cited 2023 Nov 21];12(2):116–119. Available from: https://repositorio-racs.famerp.br/racs_ol/Vol-12-2/10.pdf. https://repositorio-racs.famerp.br/racs_... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... )
12	Auxiliar no procedimento abrindo as embalagens com técnica asséptica, fornecendo antisséptico padronizado.	E17(³⁷37. Ghazali DA, Ilha-Schuelter P, Barbosa SS, Truchot J, Ceccaldi P, Tourinho F, et al. Interdisciplinary teamwork for chest tube insertion and management: an integrative review. Anaesthesiol Intensive Ther. 2021;53(5):456–65. doi: http://doi.org/10.5114/ait.2021.111349.PubMed PMID: 34870385. https://doi.org/10.5114/ait.2021.111349... ), E21(³⁸38. Seyma ZK, Meral YC, Atiye E. Nurses’ Knowledge Levels About the Care of the Patients with Chest Tube. Int J Caring Sci. 2021 [cited 2023 Nov 21];14(2):1334–42. Available from: https://www.internationaljournalofcaringsciences.org/docs/58_zeyrek_original_14_2.pdf. https://www.internationaljournalofcaring... )
13	Registrar volume de solução adicionado no frasco coletor, bem como, data, hora e nome do responsável pelo preparo.	E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E11(³¹31. Morais ACC, Lemos MM, Marques VD, Bandeira COP. Institutional protocol to standardize the chest drainage system management, from surgery to nursing care, at a regional hospital in northern Paraná. Acta Sci [Internet]. 2016;38(2):173–7. doi: http://doi.org/10.4025/actascihealthsci.v38i2.26972. https://doi.org/10.4025/actascihealthsci... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
N°	Recomendações durante inserção do DT	Código dos estudos
14	Técnicas de controle da dor não medicamentosas devem ser consideradas.	E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... )
15	Tranquilizar o paciente e monitorar sinais de desconforto, avaliando a necessidade de administrar nova dose de analgesia prescrita e informando a equipe médica.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
16	Apoiar o paciente durante o procedimento: orientá-lo quanto a sensação de frio da solução germicida e para a sensação de pressão quando infiltração do anestésico local.	E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
17	Observar atentamente o paciente durante todo o procedimento, monitorando a função respiratória, saturação periférica de oxigênio e quaisquer alterações hemodinâmicas.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
18	Conectar o dreno ao frasco coletor previamente preenchido.	E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
19	A conexão deve ser fixada de forma a manter a visibilidade.	E11(³²32. Elfaki BA, Mustafa HE, Ahmed AH. Nurses’ knowledge and Practice regard Care of Patient with Chest Drains in Sudan Heart Center, Khartoum, Sudan. IOSR-JNHS. 2016 [cited 2023 Nov 21], 5(6):1–6. Available from: https://www.iosrjournals.org/iosr-jnhs/papers/vol5-issue6/Version-4/A0506040106.pdf. https://www.iosrjournals.org/iosr-jnhs/p... ),E16(³⁶36. Gan KLJ, Tan M. Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards. Int J Evid-Based Healthc. 2015;13(2):58–65. doi: http://doi.org/10.1097/XEB.0000000000000041.PubMed PMID: 26057649. https://doi.org/10.1097/XEB.000000000000... )
20	Ligar o dreno em aspiração quando indicado e verificar o funcionamento adequado do sistema.	E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... )
21	A pele do paciente ao redor da inserção deve ser inspecionada e limpa com técnica asséptica.	E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... )
22	Realizar curativo oclusivo conforme rotina da instituição.	E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
N°	Recomendações após inserção do DT	Código dos estudos
23	Monitorar os sinais vitais a cada 2 horas, com atenção ao padrão respiratório, e avaliar e controlar a dor com o uso de analgésicos e aplicação de técnicas não medicamentosas.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E17(³⁷37. Ghazali DA, Ilha-Schuelter P, Barbosa SS, Truchot J, Ceccaldi P, Tourinho F, et al. Interdisciplinary teamwork for chest tube insertion and management: an integrative review. Anaesthesiol Intensive Ther. 2021;53(5):456–65. doi: http://doi.org/10.5114/ait.2021.111349.PubMed PMID: 34870385. https://doi.org/10.5114/ait.2021.111349... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
24	Manter o frasco de drenagem em posição vertical abaixo do nível do tórax do paciente.	E1(²¹21. Charnock Y, Evans D. Nursing management of chest drains: a systematic review. Aust Crit Care. 2001;14(4):156–60. doi: http://doi.org/10.1016/S1036-7314(05)80058-X.PubMed PMID: 11806513. https://doi.org/10.1016/S1036-7314(05)80... ), E3(²³23. Halm MA. To strip or not to strip? Physiological effects of chest tube manipulation. Am J Crit Care. 2007;16(6):609–12. doi: http://doi.org/10.4037/ajcc2007.16.6.609.PubMed PMID: 17962505. https://doi.org/10.4037/ajcc2007.16.6.60... ), E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E10AD(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... ), E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... ), E17(³⁷37. Ghazali DA, Ilha-Schuelter P, Barbosa SS, Truchot J, Ceccaldi P, Tourinho F, et al. Interdisciplinary teamwork for chest tube insertion and management: an integrative review. Anaesthesiol Intensive Ther. 2021;53(5):456–65. doi: http://doi.org/10.5114/ait.2021.111349.PubMed PMID: 34870385. https://doi.org/10.5114/ait.2021.111349... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E19AD(³⁸38. Seyma ZK, Meral YC, Atiye E. Nurses’ Knowledge Levels About the Care of the Patients with Chest Tube. Int J Caring Sci. 2021 [cited 2023 Nov 21];14(2):1334–42. Available from: https://www.internationaljournalofcaringsciences.org/docs/58_zeyrek_original_14_2.pdf. https://www.internationaljournalofcaring... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
25	Avaliar e registrar o volume e aspecto das drenagens a cada 30 minutos a 1 hora nas primeiras 3 a 4 horas após a cirurgia.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... )
26	Informar a equipe médica imediatamente se houver aumento repentino do volume de drenagem de sangue (drenagem maior que 100ml/h), exceto nas 3 primeiras horas após a cirurgia.	E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E8(²⁸28. Rashmi TR. Analytical Study on Practices Related to Care of Water Sealed Chest Drainage System. Int J Nurs Stud. 2012 [cited 2023 Nov 21];4(2):177:182. Available from: https://ijone.org/scripts/IJONE%20JOURNAL.July-Dec%2012.pdf. https://ijone.org/scripts/IJONE%20JOURNA... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E16(³⁶36. Gan KLJ, Tan M. Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards. Int J Evid-Based Healthc. 2015;13(2):58–65. doi: http://doi.org/10.1097/XEB.0000000000000041.PubMed PMID: 26057649. https://doi.org/10.1097/XEB.000000000000... )
27	Manter a tubulação de drenagem livre de dobras, evitando formação de loop dependente, caso seja inevitável, levantar o tubo a cada 15 minutos.	E1(²¹21. Charnock Y, Evans D. Nursing management of chest drains: a systematic review. Aust Crit Care. 2001;14(4):156–60. doi: http://doi.org/10.1016/S1036-7314(05)80058-X.PubMed PMID: 11806513. https://doi.org/10.1016/S1036-7314(05)80... ), E3(²³23. Halm MA. To strip or not to strip? Physiological effects of chest tube manipulation. Am J Crit Care. 2007;16(6):609–12. doi: http://doi.org/10.4037/ajcc2007.16.6.609.PubMed PMID: 17962505. https://doi.org/10.4037/ajcc2007.16.6.60... ), E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E8(²⁸28. Rashmi TR. Analytical Study on Practices Related to Care of Water Sealed Chest Drainage System. Int J Nurs Stud. 2012 [cited 2023 Nov 21];4(2):177:182. Available from: https://ijone.org/scripts/IJONE%20JOURNAL.July-Dec%2012.pdf. https://ijone.org/scripts/IJONE%20JOURNA... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E10AD(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... ), E16(³⁶36. Gan KLJ, Tan M. Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards. Int J Evid-Based Healthc. 2015;13(2):58–65. doi: http://doi.org/10.1097/XEB.0000000000000041.PubMed PMID: 26057649. https://doi.org/10.1097/XEB.000000000000... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... )
28	Observar infiltração de ar ao redor da inserção do tubo (enfisema subcutâneo).	E2(²²22. Parra AV, Amorim RC, Wigman SE, Baccaria LM. Withdrawal of thorax drain in postoperative of cardiac surgery. Arq Ciênc Saúde [Internet]. 2005 [cited 2023 Nov 21];12(2):116–119. Available from: https://repositorio-racs.famerp.br/racs_ol/Vol-12-2/10.pdf. https://repositorio-racs.famerp.br/racs_... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E16(³⁶36. Gan KLJ, Tan M. Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards. Int J Evid-Based Healthc. 2015;13(2):58–65. doi: http://doi.org/10.1097/XEB.0000000000000041.PubMed PMID: 26057649. https://doi.org/10.1097/XEB.000000000000... )
29	Observar se há oscilação do fluído na extensão do tubo de drenagem, indicando o bom funcionamento do sistema.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E16(³⁶36. Gan KLJ, Tan M. Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards. Int J Evid-Based Healthc. 2015;13(2):58–65. doi: http://doi.org/10.1097/XEB.0000000000000041.PubMed PMID: 26057649. https://doi.org/10.1097/XEB.000000000000... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E20AD(³⁹39. Ghazali DA, Ilha-Schuelter P, Barreyre L, Stephan O, Barbosa SS, Oriot D, et al. Development and validation of the frst performance assessment scale for interdisciplinary chest tube insertion: a prospective multicenter study. Eur J Trauma Emerg Surg. 2022;48(5):4069–78. doi: http://doi.org/10.1007/s00068-022-01928-9.PubMed PMID: 35376968. https://doi.org/10.1007/s00068-022-01928... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
30	Observar borbulhamento que deve ser leve e comunicar à equipe médica se houver borbulhamento excessivo ou repentino.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ),E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E8(²⁸28. Rashmi TR. Analytical Study on Practices Related to Care of Water Sealed Chest Drainage System. Int J Nurs Stud. 2012 [cited 2023 Nov 21];4(2):177:182. Available from: https://ijone.org/scripts/IJONE%20JOURNAL.July-Dec%2012.pdf. https://ijone.org/scripts/IJONE%20JOURNA... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E10AD(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... ), E12AD(³²32. Elfaki BA, Mustafa HE, Ahmed AH. Nurses’ knowledge and Practice regard Care of Patient with Chest Drains in Sudan Heart Center, Khartoum, Sudan. IOSR-JNHS. 2016 [cited 2023 Nov 21], 5(6):1–6. Available from: https://www.iosrjournals.org/iosr-jnhs/papers/vol5-issue6/Version-4/A0506040106.pdf. https://www.iosrjournals.org/iosr-jnhs/p... ), E13(³³33. Lu C, Jin YH, Gao W, Shi YX, Xia X, Sun WX, et al. Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study. J Clin Nurs. 2018;27(5-6):1013–21. doi: http://doi.org/10.1111/jocn.14127.PubMed PMID: 29076204. https://doi.org/10.1111/jocn.14127... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E20AD(³⁹39. Ghazali DA, Ilha-Schuelter P, Barreyre L, Stephan O, Barbosa SS, Oriot D, et al. Development and validation of the frst performance assessment scale for interdisciplinary chest tube insertion: a prospective multicenter study. Eur J Trauma Emerg Surg. 2022;48(5):4069–78. doi: http://doi.org/10.1007/s00068-022-01928-9.PubMed PMID: 35376968. https://doi.org/10.1007/s00068-022-01928... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
N°	Recomendações após inserção do DT	Código dos estudos
31	Clampear os drenos sempre que o frasco de drenagem estiver posicionado acima do nível do tórax do paciente, assegurando que o clampe fique no local pelo menor tempo possível.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E10AD(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... ), E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E19AD(³⁸38. Seyma ZK, Meral YC, Atiye E. Nurses’ Knowledge Levels About the Care of the Patients with Chest Tube. Int J Caring Sci. 2021 [cited 2023 Nov 21];14(2):1334–42. Available from: https://www.internationaljournalofcaringsciences.org/docs/58_zeyrek_original_14_2.pdf. https://www.internationaljournalofcaring... )
32	Não clampear o sistema de drenagem mesmo durante o transporte do paciente, apenas deve-se manter o sistema abaixo do nível do tórax do paciente.	E1(²¹21. Charnock Y, Evans D. Nursing management of chest drains: a systematic review. Aust Crit Care. 2001;14(4):156–60. doi: http://doi.org/10.1016/S1036-7314(05)80058-X.PubMed PMID: 11806513. https://doi.org/10.1016/S1036-7314(05)80... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E10AD(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... ), E12AD(³²32. Elfaki BA, Mustafa HE, Ahmed AH. Nurses’ knowledge and Practice regard Care of Patient with Chest Drains in Sudan Heart Center, Khartoum, Sudan. IOSR-JNHS. 2016 [cited 2023 Nov 21], 5(6):1–6. Available from: https://www.iosrjournals.org/iosr-jnhs/papers/vol5-issue6/Version-4/A0506040106.pdf. https://www.iosrjournals.org/iosr-jnhs/p... ), E13(³³33. Lu C, Jin YH, Gao W, Shi YX, Xia X, Sun WX, et al. Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study. J Clin Nurs. 2018;27(5-6):1013–21. doi: http://doi.org/10.1111/jocn.14127.PubMed PMID: 29076204. https://doi.org/10.1111/jocn.14127... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ),
33	Clampear o sistema com a mão, pelo menor tempo possível (menos de 1 minuto), apenas para troca do selo d’água, ou clampeado com pinças se houver desconexão acidental do sistema.	E1(²¹21. Charnock Y, Evans D. Nursing management of chest drains: a systematic review. Aust Crit Care. 2001;14(4):156–60. doi: http://doi.org/10.1016/S1036-7314(05)80058-X.PubMed PMID: 11806513. https://doi.org/10.1016/S1036-7314(05)80... ), E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E5(²⁵25. Lima AG, Rocha ERF, Seabra JCT, et al. The influence of clamp usage on clot deposit formation inside thoracic drains. Rev Col Bras Cir. 2008;35(2):79–82. doi: http://doi.org/10.1590/S0100-69912008000200003. https://doi.org/10.1590/S0100-6991200800... ), E8(²⁸28. Rashmi TR. Analytical Study on Practices Related to Care of Water Sealed Chest Drainage System. Int J Nurs Stud. 2012 [cited 2023 Nov 21];4(2):177:182. Available from: https://ijone.org/scripts/IJONE%20JOURNAL.July-Dec%2012.pdf. https://ijone.org/scripts/IJONE%20JOURNA... ), E10AD(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... ), E13(³³33. Lu C, Jin YH, Gao W, Shi YX, Xia X, Sun WX, et al. Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study. J Clin Nurs. 2018;27(5-6):1013–21. doi: http://doi.org/10.1111/jocn.14127.PubMed PMID: 29076204. https://doi.org/10.1111/jocn.14127... ),E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E19AD(³⁸38. Seyma ZK, Meral YC, Atiye E. Nurses’ Knowledge Levels About the Care of the Patients with Chest Tube. Int J Caring Sci. 2021 [cited 2023 Nov 21];14(2):1334–42. Available from: https://www.internationaljournalofcaringsciences.org/docs/58_zeyrek_original_14_2.pdf. https://www.internationaljournalofcaring... ), E20AD(³⁹39. Ghazali DA, Ilha-Schuelter P, Barreyre L, Stephan O, Barbosa SS, Oriot D, et al. Development and validation of the frst performance assessment scale for interdisciplinary chest tube insertion: a prospective multicenter study. Eur J Trauma Emerg Surg. 2022;48(5):4069–78. doi: http://doi.org/10.1007/s00068-022-01928-9.PubMed PMID: 35376968. https://doi.org/10.1007/s00068-022-01928... )
34	Desencorajar o uso de clamp ou braçadeira.	E5(²⁵25. Lima AG, Rocha ERF, Seabra JCT, et al. The influence of clamp usage on clot deposit formation inside thoracic drains. Rev Col Bras Cir. 2008;35(2):79–82. doi: http://doi.org/10.1590/S0100-69912008000200003. https://doi.org/10.1590/S0100-6991200800... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E10AD(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... ), E13(³³33. Lu C, Jin YH, Gao W, Shi YX, Xia X, Sun WX, et al. Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study. J Clin Nurs. 2018;27(5-6):1013–21. doi: http://doi.org/10.1111/jocn.14127.PubMed PMID: 29076204. https://doi.org/10.1111/jocn.14127... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E19AD(³⁸38. Seyma ZK, Meral YC, Atiye E. Nurses’ Knowledge Levels About the Care of the Patients with Chest Tube. Int J Caring Sci. 2021 [cited 2023 Nov 21];14(2):1334–42. Available from: https://www.internationaljournalofcaringsciences.org/docs/58_zeyrek_original_14_2.pdf. https://www.internationaljournalofcaring... )
35	Trocar o selo d’água ou o frasco de drenagem sempre que houver volume de drenagem maior que 500 ml acumulada no frasco.	E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E13(³³33. Lu C, Jin YH, Gao W, Shi YX, Xia X, Sun WX, et al. Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study. J Clin Nurs. 2018;27(5-6):1013–21. doi: http://doi.org/10.1111/jocn.14127.PubMed PMID: 29076204. https://doi.org/10.1111/jocn.14127... ), E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... )
36	Verificar a medida de drenagem (esta não deve exceder 200 mL/h nas primeiras duas a seis horas).	E10AD(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... )
37	Verificar a drenagem rotineiramente (a cada 24 horas).	E9(²⁸28. Rashmi TR. Analytical Study on Practices Related to Care of Water Sealed Chest Drainage System. Int J Nurs Stud. 2012 [cited 2023 Nov 21];4(2):177:182. Available from: https://ijone.org/scripts/IJONE%20JOURNAL.July-Dec%2012.pdf. https://ijone.org/scripts/IJONE%20JOURNA... ), E10AD(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... ), E13(³³33. Lu C, Jin YH, Gao W, Shi YX, Xia X, Sun WX, et al. Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study. J Clin Nurs. 2018;27(5-6):1013–21. doi: http://doi.org/10.1111/jocn.14127.PubMed PMID: 29076204. https://doi.org/10.1111/jocn.14127... ), E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... ), E20AD(³⁹39. Ghazali DA, Ilha-Schuelter P, Barreyre L, Stephan O, Barbosa SS, Oriot D, et al. Development and validation of the frst performance assessment scale for interdisciplinary chest tube insertion: a prospective multicenter study. Eur J Trauma Emerg Surg. 2022;48(5):4069–78. doi: http://doi.org/10.1007/s00068-022-01928-9.PubMed PMID: 35376968. https://doi.org/10.1007/s00068-022-01928... )
38	Certificar de que o dreno esteja conectado na porta correta de entrada do frasco coletor, bem como, em caso de dreno em aspiração, se a aspiração está ligada corretamente.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E15(³⁶36. Gan KLJ, Tan M. Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards. Int J Evid-Based Healthc. 2015;13(2):58–65. doi: http://doi.org/10.1097/XEB.0000000000000041.PubMed PMID: 26057649. https://doi.org/10.1097/XEB.000000000000... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
39	Providenciar reposição, sempre que preciso, da quantidade de fluídos no frasco de selo d’água, garantido que a haste fique submersa entre 1,5 e 3,0 centímetros ou, no frasco de aspiração, 20 centímetros; pois este volume que determinará a pressão que está sendo aplicada de aspiração.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
40	Manter a pressão de vácuo entre 10 e 20 cmH2O.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E16(³⁶36. Gan KLJ, Tan M. Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards. Int J Evid-Based Healthc. 2015;13(2):58–65. doi: http://doi.org/10.1097/XEB.0000000000000041.PubMed PMID: 26057649. https://doi.org/10.1097/XEB.000000000000... )
41	Realizar troca de filtro de ar particulado de alta eficiência (HEPA), indicada nos pacientes em isolamento por risco de aerossolização, como SARS-CoV-2, por paciente.	E16(³⁶36. Gan KLJ, Tan M. Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards. Int J Evid-Based Healthc. 2015;13(2):58–65. doi: http://doi.org/10.1097/XEB.0000000000000041.PubMed PMID: 26057649. https://doi.org/10.1097/XEB.000000000000... )
42	Orientar o paciente e a família sobre o que será feito, os cuidados com o sistema de drenagem e a posição correta em que o sistema deve ser mantido.	E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ),E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... ), E17(³⁷37. Ghazali DA, Ilha-Schuelter P, Barbosa SS, Truchot J, Ceccaldi P, Tourinho F, et al. Interdisciplinary teamwork for chest tube insertion and management: an integrative review. Anaesthesiol Intensive Ther. 2021;53(5):456–65. doi: http://doi.org/10.5114/ait.2021.111349.PubMed PMID: 34870385. https://doi.org/10.5114/ait.2021.111349... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
43	Incentivar mobilização, tosse, e inspirações profundas para facilitar a drenagem.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ),E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E20AD(³⁹39. Ghazali DA, Ilha-Schuelter P, Barreyre L, Stephan O, Barbosa SS, Oriot D, et al. Development and validation of the frst performance assessment scale for interdisciplinary chest tube insertion: a prospective multicenter study. Eur J Trauma Emerg Surg. 2022;48(5):4069–78. doi: http://doi.org/10.1007/s00068-022-01928-9.PubMed PMID: 35376968. https://doi.org/10.1007/s00068-022-01928... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
44	Realizar troca de curativo no local de inserção uma vez ao dia, observando se o local está limpo, seco e sem odor e/ou sinais de infecção.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E13(³³33. Lu C, Jin YH, Gao W, Shi YX, Xia X, Sun WX, et al. Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study. J Clin Nurs. 2018;27(5-6):1013–21. doi: http://doi.org/10.1111/jocn.14127.PubMed PMID: 29076204. https://doi.org/10.1111/jocn.14127... ), E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... ), E16(³⁶36. Gan KLJ, Tan M. Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards. Int J Evid-Based Healthc. 2015;13(2):58–65. doi: http://doi.org/10.1097/XEB.0000000000000041.PubMed PMID: 26057649. https://doi.org/10.1097/XEB.000000000000... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E20AD(³⁹39. Ghazali DA, Ilha-Schuelter P, Barreyre L, Stephan O, Barbosa SS, Oriot D, et al. Development and validation of the frst performance assessment scale for interdisciplinary chest tube insertion: a prospective multicenter study. Eur J Trauma Emerg Surg. 2022;48(5):4069–78. doi: http://doi.org/10.1007/s00068-022-01928-9.PubMed PMID: 35376968. https://doi.org/10.1007/s00068-022-01928... )
45	Realizar o curativo com técnica asséptica, podendo ser feito com gaze e solução fisiológica 0,9%.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... )
46	Usar, quando disponível, película transparente para realização do curativo, pois diminui o risco de infecções e diminui as trocas pois o curativo pode ser mantido de três a sete dias;	E17(³⁷37. Ghazali DA, Ilha-Schuelter P, Barbosa SS, Truchot J, Ceccaldi P, Tourinho F, et al. Interdisciplinary teamwork for chest tube insertion and management: an integrative review. Anaesthesiol Intensive Ther. 2021;53(5):456–65. doi: http://doi.org/10.5114/ait.2021.111349.PubMed PMID: 34870385. https://doi.org/10.5114/ait.2021.111349... ), E21(⁴⁰40. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: a practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. doi: http://doi.org/10.1111/jan.14743.PubMed PMID: 33543511. https://doi.org/10.1111/jan.14743... )
47	Realizar a aplicação de curativo de espuma revestido com silicone com borda adesiva.	E15(³⁵35. Wood MD, Powers J, Rechter JL. Comparative evaluation of chest tube insertion site dressings: a randomized controlled trial. Am J Crit Care. 2019;28(6):415–23. doi: http://doi.org/10.4037/ajcc2019645.PubMed PMID: 31676515. https://doi.org/10.4037/ajcc2019645... )
48	Inspecionar o local de inserção do dreno diariamente, observando a presença de sinais de infecção e o posicionamento adequado.	E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E13(³³33. Lu C, Jin YH, Gao W, Shi YX, Xia X, Sun WX, et al. Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study. J Clin Nurs. 2018;27(5-6):1013–21. doi: http://doi.org/10.1111/jocn.14127.PubMed PMID: 29076204. https://doi.org/10.1111/jocn.14127... ), E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... ), E16(³⁶36. Gan KLJ, Tan M. Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards. Int J Evid-Based Healthc. 2015;13(2):58–65. doi: http://doi.org/10.1097/XEB.0000000000000041.PubMed PMID: 26057649. https://doi.org/10.1097/XEB.000000000000... ), E20AD(³⁹39. Ghazali DA, Ilha-Schuelter P, Barreyre L, Stephan O, Barbosa SS, Oriot D, et al. Development and validation of the frst performance assessment scale for interdisciplinary chest tube insertion: a prospective multicenter study. Eur J Trauma Emerg Surg. 2022;48(5):4069–78. doi: http://doi.org/10.1007/s00068-022-01928-9.PubMed PMID: 35376968. https://doi.org/10.1007/s00068-022-01928... )
49	Cobrir imediatamente o local com gaze e aplicar pressão para evitar que a pressão inspiratória negativa permita a entrada de ar na região intratorácica, caso o dreno torácico seja desalojado acidentalmente. Informar o médico, organizar material para reinserção do tubo, tranquilizar o paciente e monitorá-lo quanto a sinais de pneumotórax hipertensivo.	E12AD(³²32. Elfaki BA, Mustafa HE, Ahmed AH. Nurses’ knowledge and Practice regard Care of Patient with Chest Drains in Sudan Heart Center, Khartoum, Sudan. IOSR-JNHS. 2016 [cited 2023 Nov 21], 5(6):1–6. Available from: https://www.iosrjournals.org/iosr-jnhs/papers/vol5-issue6/Version-4/A0506040106.pdf. https://www.iosrjournals.org/iosr-jnhs/p... )
50	Massagear o dreno, caso esteja obstruído, com a mão para tentar remover o coágulo ou fibrina.	E3(²³23. Halm MA. To strip or not to strip? Physiological effects of chest tube manipulation. Am J Crit Care. 2007;16(6):609–12. doi: http://doi.org/10.4037/ajcc2007.16.6.609.PubMed PMID: 17962505. https://doi.org/10.4037/ajcc2007.16.6.60... ), E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E10AD(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... )
51	Desencorajar a ordenha do dreno.	E3(²³23. Halm MA. To strip or not to strip? Physiological effects of chest tube manipulation. Am J Crit Care. 2007;16(6):609–12. doi: http://doi.org/10.4037/ajcc2007.16.6.609.PubMed PMID: 17962505. https://doi.org/10.4037/ajcc2007.16.6.60... ), E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E5(²⁵25. Lima AG, Rocha ERF, Seabra JCT, et al. The influence of clamp usage on clot deposit formation inside thoracic drains. Rev Col Bras Cir. 2008;35(2):79–82. doi: http://doi.org/10.1590/S0100-69912008000200003. https://doi.org/10.1590/S0100-6991200800... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... ), E10AD(³⁰30. Silva LDC, Brito LL. Mediastinal and pleural drains handling: is there scientific evidence? J Manag Prim Heal Care [Internet]. 2015;6(1):86–102. doi: http://doi.org/10.14295/jmphc.v6i1.236. https://doi.org/10.14295/jmphc.v6i1.236... ), E12AD(³²32. Elfaki BA, Mustafa HE, Ahmed AH. Nurses’ knowledge and Practice regard Care of Patient with Chest Drains in Sudan Heart Center, Khartoum, Sudan. IOSR-JNHS. 2016 [cited 2023 Nov 21], 5(6):1–6. Available from: https://www.iosrjournals.org/iosr-jnhs/papers/vol5-issue6/Version-4/A0506040106.pdf. https://www.iosrjournals.org/iosr-jnhs/p... ), E13(³³33. Lu C, Jin YH, Gao W, Shi YX, Xia X, Sun WX, et al. Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study. J Clin Nurs. 2018;27(5-6):1013–21. doi: http://doi.org/10.1111/jocn.14127.PubMed PMID: 29076204. https://doi.org/10.1111/jocn.14127... ), E19AD(³⁸38. Seyma ZK, Meral YC, Atiye E. Nurses’ Knowledge Levels About the Care of the Patients with Chest Tube. Int J Caring Sci. 2021 [cited 2023 Nov 21];14(2):1334–42. Available from: https://www.internationaljournalofcaringsciences.org/docs/58_zeyrek_original_14_2.pdf. https://www.internationaljournalofcaring... )
52	Realizar ordenha quando solicitado pelo médico ou para prevenir obstrução.	E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... ), E8(²⁸28. Rashmi TR. Analytical Study on Practices Related to Care of Water Sealed Chest Drainage System. Int J Nurs Stud. 2012 [cited 2023 Nov 21];4(2):177:182. Available from: https://ijone.org/scripts/IJONE%20JOURNAL.July-Dec%2012.pdf. https://ijone.org/scripts/IJONE%20JOURNA... ), E12AD(³²32. Elfaki BA, Mustafa HE, Ahmed AH. Nurses’ knowledge and Practice regard Care of Patient with Chest Drains in Sudan Heart Center, Khartoum, Sudan. IOSR-JNHS. 2016 [cited 2023 Nov 21], 5(6):1–6. Available from: https://www.iosrjournals.org/iosr-jnhs/papers/vol5-issue6/Version-4/A0506040106.pdf. https://www.iosrjournals.org/iosr-jnhs/p... ),E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... )
53	Monitorar quanto aos sinais de resolução do pneumotórax, hemotórax, entre outros; através da observação do volume e aspecto das drenagens.	E14(³⁴34. Almeida RC, Souza PA, Santana RF, Luna AA. Nursing intervention: post-operative care with chest tube in adults. Rev Rene. 2018;19:e3332. doi: http://doi.org/10.15253/2175-6783.2018193332. https://doi.org/10.15253/2175-6783.20181... ), E18AD(¹⁰10. Hasselmann BNO, Ranção CS, Tavares GS, Almeida LF, Camerini FG, Paula VG. Good practices in nursing in the use of chest tubes: an integrative review. Glob Acad Nurs [Internet]. 2021;2(2):e173. doi: http://doi.org/10.5935/2675-5602.20200173. https://doi.org/10.5935/2675-5602.202001... ), E20AD(³⁹39. Ghazali DA, Ilha-Schuelter P, Barreyre L, Stephan O, Barbosa SS, Oriot D, et al. Development and validation of the frst performance assessment scale for interdisciplinary chest tube insertion: a prospective multicenter study. Eur J Trauma Emerg Surg. 2022;48(5):4069–78. doi: http://doi.org/10.1007/s00068-022-01928-9.PubMed PMID: 35376968. https://doi.org/10.1007/s00068-022-01928... )
54	Aplicar compressa fria 20 minutos antes da retirada do dreno torácico para redução da intensidade da dor associada a retirada do tubo.	E6(²⁶26. Demir Y, Kborsbid L. The effect of cold application in combination with standard analgesic administration on pain and anxiety during chest tube removal: a single-blinded, randomized, double-controlled study. Pain Manag Nurs. 2010;11(3):186–96. doi: http://doi.org/10.1016/j.pmn.2009.09.002.PubMed PMID: 20728068. https://doi.org/10.1016/j.pmn.2009.09.00... )
55	Administrar analgesia, conforme prescrição médica, no mínimo 30 minutos antes da retirada do dreno.	E1(²¹21. Charnock Y, Evans D. Nursing management of chest drains: a systematic review. Aust Crit Care. 2001;14(4):156–60. doi: http://doi.org/10.1016/S1036-7314(05)80058-X.PubMed PMID: 11806513. https://doi.org/10.1016/S1036-7314(05)80... ), E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E6(²⁶26. Demir Y, Kborsbid L. The effect of cold application in combination with standard analgesic administration on pain and anxiety during chest tube removal: a single-blinded, randomized, double-controlled study. Pain Manag Nurs. 2010;11(3):186–96. doi: http://doi.org/10.1016/j.pmn.2009.09.002.PubMed PMID: 20728068. https://doi.org/10.1016/j.pmn.2009.09.00... )
56	Instruir o paciente para retirada do dreno torácico, a realizar a manobra de Valsalva, bem como sobre o procedimento que será realizado.	E2(²²22. Parra AV, Amorim RC, Wigman SE, Baccaria LM. Withdrawal of thorax drain in postoperative of cardiac surgery. Arq Ciênc Saúde [Internet]. 2005 [cited 2023 Nov 21];12(2):116–119. Available from: https://repositorio-racs.famerp.br/racs_ol/Vol-12-2/10.pdf. https://repositorio-racs.famerp.br/racs_... ), E9(²⁹29. Mohammed HM. Chest tube care in critically ill patient: a comprehensive review. Egypt J Chest Dis Tuberc. 2015;64(4):849–55. doi: http://doi.org/10.1016/j.ejcdt.2015.06.002. https://doi.org/10.1016/j.ejcdt.2015.06.... )
57	Preparar material para retirada do dreno e curativo.	E2(²²22. Parra AV, Amorim RC, Wigman SE, Baccaria LM. Withdrawal of thorax drain in postoperative of cardiac surgery. Arq Ciênc Saúde [Internet]. 2005 [cited 2023 Nov 21];12(2):116–119. Available from: https://repositorio-racs.famerp.br/racs_ol/Vol-12-2/10.pdf. https://repositorio-racs.famerp.br/racs_... ), E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... ), E7(²⁷27. Lúcio VV, Araújo APS. Nursing Care in Thoracic Drainage: a Literature Review. UNOPAR Cient Ciênc Biol Saúde. 2011 ; [cited 2023 Nov 21];13:307–14. Available from: https://journalhealthscience.pgsskroton.com.br/article/download/1079/1034. https://journalhealthscience.pgsskroton.... )
58	Posicionar o paciente em posição dorsal com o braço elevado sobre a cabeça.	E2(²²22. Parra AV, Amorim RC, Wigman SE, Baccaria LM. Withdrawal of thorax drain in postoperative of cardiac surgery. Arq Ciênc Saúde [Internet]. 2005 [cited 2023 Nov 21];12(2):116–119. Available from: https://repositorio-racs.famerp.br/racs_ol/Vol-12-2/10.pdf. https://repositorio-racs.famerp.br/racs_... )
59	Realizar curativo oclusivo após a retirada do dreno.	E2(²²22. Parra AV, Amorim RC, Wigman SE, Baccaria LM. Withdrawal of thorax drain in postoperative of cardiac surgery. Arq Ciênc Saúde [Internet]. 2005 [cited 2023 Nov 21];12(2):116–119. Available from: https://repositorio-racs.famerp.br/racs_ol/Vol-12-2/10.pdf. https://repositorio-racs.famerp.br/racs_... ), E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... )
60	Monitorar local da ferida quanto aos sinais de infecção e retirar os pontos sete dias após a retirada do dreno.	E2(²²22. Parra AV, Amorim RC, Wigman SE, Baccaria LM. Withdrawal of thorax drain in postoperative of cardiac surgery. Arq Ciênc Saúde [Internet]. 2005 [cited 2023 Nov 21];12(2):116–119. Available from: https://repositorio-racs.famerp.br/racs_ol/Vol-12-2/10.pdf. https://repositorio-racs.famerp.br/racs_... ), E4(²⁴24. Sullivan B. Nursing management of patients with a chest drain. Br J Nurs. 2008;17(6):388–93. doi: http://doi.org/10.12968/bjon.2008.17.6.28906.PubMed PMID: 18414310. https://doi.org/10.12968/bjon.2008.17.6.... )

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E-mail: reeusp@usp.br

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[1] Autor correspondente: Elisiane Goveia da Silva, Rua Sarmento Leite, 245, Centro, 90050-170 – Porto Alegre, RS, Brasil, e-mail: elisiane.silva@ufcspa.edu.br

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Cuidados de enfermagem ao paciente adulto com drenagem torácica: uma revisão de escopo* * Extraído da dissertação “Protocolo assistencial de enfermagem para pacientes submetidos a drenagem torácica”, Universidade Federal de Ciências da Saúde de Porto Alegre, 2023.

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Cuidados de enfermagem ao paciente adulto com drenagem torácica: uma revisão de escopo^* * Extraído da dissertação “Protocolo assistencial de enfermagem para pacientes submetidos a drenagem torácica”, Universidade Federal de Ciências da Saúde de Porto Alegre, 2023.