Randomized Multicenter Trial of -8 cmH2O versus -15 cmH2O Intrathoracic Pressure Digital Thoracic Drainage for Air Leaks after Anatomical Pulmonary Resection Short title: Optimal pressure for thoracic drainage

Kazuya Takamochi, Makoto Endo, Kazuhito Funai, Tomohiro Haruki, Morihito Okada, Masahiro Tsuboi, Yoshitaka Kitamura, Shiaki Oh, Shuko Nojiri, Kenji Suzuki, and the Advanced Clinical Trial Chest Surgery Group (ACTG)  |  August 29, 2025

This multicenter, randomized controlled trial compared two intrathoracic pressure settings (−8 cmH₂O vs. −15 cmH₂O) in digital pleural drainage for patients with moderate air leaks after lung resection. No significant differences were found in prolonged air leak rates, air leak duration, chest tube duration, or hospital stay between groups. The findings suggest that adjusting negative intrathoracic pressure above −8 cmH₂O does not accelerate air leak resolution, and pressure settings can be tailored to individual patient needs.

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