Doctors in Denmark studied patients who had special tubes placed in their lungs to drain fluid. These tubes, called indwelling pleural catheters, help people with recurring fluid buildup, but they can sometimes cause infections. Researchers looked at 54 patients with these tubes over four years and found that about 1 in 4 developed an infection, usually caused by a common bacteria called Staphylococci. Interestingly, patients with tube-related infections needed fewer days of antibiotics and hospital stays compared to people who got lung infections without tubes. However, patients with tube-related infections were sicker overall and had higher death rates. The good news is that actual deaths directly caused by the infection were rare in both groups.
The Quick Take
- What they studied: Whether special drainage tubes placed in the lungs to remove fluid cause infections, and how these infections compare to lung infections that happen without tubes
- Who participated: 54 patients who had drainage tubes placed in their lungs between 2018-2022, plus 28 comparison patients who got lung infections without tubes. All were treated at one Danish hospital clinic.
- Key finding: About 1 in 4 patients with drainage tubes developed an infection, usually within 5 months. These infections were almost always caused by Staphylococci bacteria. Patients with tube-related infections needed shorter hospital stays (13 days vs 17 days) but were overall sicker and had higher death rates from all causes (23% vs 4%), though actual deaths from the infection itself were similar in both groups (8% vs 7%).
- What it means for you: If you need a drainage tube for lung fluid, know that infection is a real but manageable risk. The good news is that when infections do happen, they respond well to treatment and rarely cause death directly from the infection. However, patients with these tubes tend to be sicker overall, which affects survival rates. Talk with your doctor about whether the benefits of the tube outweigh these risks for your specific situation.
The Research Details
Researchers looked back at medical records from 2018 to 2022 at a Danish hospital to find all patients who either had drainage tubes placed in their lungs or were treated for lung infections. They compared two groups: 54 patients with tubes and 28 patients without tubes who developed infections. They recorded information about the patients’ age, what bacteria caused the infection, how long patients stayed in the hospital, how many days they needed antibiotics, and whether they survived.
This type of study is called a retrospective case-control study, meaning doctors looked backward at what already happened instead of following patients forward in time. The researchers used a scoring system called RAPID to measure how sick each patient was when they arrived at the hospital. This score considers factors like kidney function, age, how much pus was present, where the infection came from, and nutritional status.
Understanding infection risks with drainage tubes is important because more and more patients are getting these tubes to manage chronic lung fluid problems. By comparing patients with tube-related infections to those with regular lung infections, doctors can better understand whether the tube itself changes how infections develop and how serious they become. This helps doctors make better decisions about who should get these tubes and how to monitor them.
This study has some strengths and weaknesses. The strength is that it looked at real patient data from actual medical records, so the information is accurate. However, the study is relatively small (only 82 patients total) and comes from just one hospital in Denmark, so the results might not apply everywhere. The researchers identified the bacteria causing infection in 85% of tube-related cases but only 50% of non-tube cases, which makes comparison a bit harder. The study is also retrospective, meaning doctors relied on what was already written down rather than carefully tracking patients forward in time.
What the Results Show
Among the 54 patients with drainage tubes, 13 patients (24%) developed infections. On average, infections appeared about 5 months after the tube was placed. The monthly risk of infection was about 1%, which is lower than some earlier studies reported. The bacteria causing these infections were almost always Staphylococci (91% of cases), which is a common skin bacteria that can cause serious infections.
When comparing tube-related infections to regular lung infections, patients with tube-related infections needed fewer days of intravenous antibiotics (10 days versus 15 days) and shorter hospital stays (13 days versus 17 days). This suggests that tube-related infections may be easier to treat once they’re identified.
However, patients with tube-related infections were sicker overall when they arrived at the hospital. Using the RAPID scoring system, 62% of tube-related infection patients had high severity scores compared to only 25% of non-tube patients. Additionally, 30-day mortality (death within one month) was higher in the tube group at 23% compared to 4% in the non-tube group.
The important caveat is that deaths directly caused by the infection itself were similar in both groups (8% in the tube group versus 7% in the non-tube group). This means the higher death rate in tube patients was likely due to their overall sicker condition, not the infection itself.
The study found that longer exposure to the drainage tube was associated with higher infection rates, but the pattern of infections remained consistent with what doctors have seen before. The bacteria causing infections stayed the same (mostly Staphylococci), and the overall infection-related death rate remained low. Patients with tube-related infections were able to switch from intravenous antibiotics to oral antibiotics more quickly, suggesting good response to treatment.
Earlier studies reported monthly infection rates of around 3-5% for drainage tubes. This Danish study found a lower rate of about 1% per month, which is good news. The finding that Staphylococci is the main bacteria matches what other studies have shown. The study confirms that tube-related infections are generally manageable and rarely cause death directly from the infection, consistent with previous research.
The study has several important limitations. First, it’s relatively small with only 82 patients total, so results might not apply to larger populations. Second, it comes from only one hospital in Denmark, so results might be different in other countries or healthcare systems. Third, doctors were able to identify the bacteria in only 85% of tube-related infections and 50% of non-tube infections, which makes some comparisons less reliable. Fourth, the study looked backward at medical records rather than carefully following patients forward, so some information might be incomplete or recorded differently. Finally, patients with tubes were generally sicker to begin with, which makes it hard to know whether the tube itself caused the higher death rates or if sicker patients were more likely to get tubes.
The Bottom Line
Based on this research, drainage tubes for chronic lung fluid appear to be reasonably safe with infection rates around 1% per month. If an infection does develop, it typically responds well to antibiotics and rarely causes death directly from the infection. Doctors should monitor patients regularly for signs of infection (fever, increased shortness of breath, chest pain) and be prepared to start antibiotics quickly if infection is suspected. Confidence level: Moderate - this is one study from one hospital, so results should be confirmed by larger studies.
This research matters most for people with chronic lung fluid problems who are considering getting a drainage tube, their family members, and their doctors. It’s particularly relevant for people with cancer-related fluid buildup or other conditions causing repeated fluid accumulation. People with severe heart or kidney disease should discuss these findings with their doctors, as they may have higher overall risk. This research is less relevant for people with acute (sudden) lung infections or those who don’t need long-term drainage.
If you get a drainage tube, infections typically appear within 2-5 months, though they can happen anytime. If an infection develops, you should see improvement within 1-2 weeks of starting antibiotics. Most patients recover from the infection within 2-3 weeks of treatment. However, overall health outcomes depend on your other medical conditions, not just the infection itself.
Want to Apply This Research?
- If you have a drainage tube, track daily temperature (especially any fever above 100.4°F), shortness of breath level (on a scale of 1-10), chest pain or discomfort, and any changes in fluid drainage color or amount. Note antibiotic doses and dates taken.
- Set daily reminders to check your temperature and monitor the drainage tube site for redness, swelling, or warmth. Keep a log of any symptoms and share it with your doctor at appointments. Report fever, increased shortness of breath, or changes in drainage immediately rather than waiting for your next appointment.
- Create a weekly summary of your symptoms and tube function to discuss with your healthcare team. Track patterns over time - for example, whether symptoms worsen at certain times or after certain activities. This helps your doctor catch early signs of infection before they become serious. Set monthly reminders to review your records with your doctor.
This research summary is for educational purposes only and should not replace professional medical advice. If you have a drainage tube or are considering one, discuss these findings with your doctor who knows your complete medical history. The infection risks and benefits of drainage tubes vary depending on your specific condition, age, and other health factors. Do not start, stop, or change any medical treatment based on this information without consulting your healthcare provider. If you experience fever, severe shortness of breath, or chest pain, seek immediate medical attention.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.