Optimal Suction Strategy After Pulmonary Resection Using a Digital Drainage System With a Single Blake Drain: A Randomized Study

Conor M. Maxwell, Benny Weksler, Kevin Shahbahrami, Brent Williams, Kurt DeHaven, Pam Kuchta, Kara Specht, and Hiran C. Fernando  |  July 31, 2025

This randomized study compared standard suction (−20 cmH₂O) and low suction (−8 cmH₂O) using digital drainage after minimally invasive lung resection. Both approaches, with a single 24 Fr Blake drain and a removal threshold of 450 mL/24 h, were safe and effective. However, low suction did not shorten air leak duration and was associated with more pleural interventions and a trend toward increased subcutaneous emphysema. The findings suggest standard suction may be preferable when air leaks are present.

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