Section 1 . Definition of the Centres participating in the study

Institution/Hospital

Department

Country

Type of surgery performed

Esophageal   Lung     Mediastinal  Cardiac    

Section 2 . Thoracic drains

Which thoracic drains do you prefer:

	Major Lung Resection	Wedge resection	VATS	Pneumothorax Surgery	Oesophageal Cancer Surgery	Empyema	Esophageal leakage
PVC Straight
PVC Thermosensitive
PVC Heparin Coated
Silicone
Silicon Heparin Coated
Others

Section 3 . Chest drainage and aspiration systems (CDS)

Which chest drainage system (cds) do you prefer  (see figure below)?

	Major Lung Resection	Wedge resection	VATS	Pneumothorax Surgery	Oesophageal Cancer Surgery	Empyema	Esophageal leakage
water valve / water suction disposable
water valve / dry suction  disposable
dry valve / dry suction  disposable
two bottle with  suction control
one bottle  with  suction control
chest drain valve ( Heimlich type or other )

Section 4 . CDS details

1. When do you use a disposable dual fluid collection chamber ?

Never
To separate two drains from the same hemithorax
To drain the right and left chest separately 
Both of the above  
To drain the mediastinum and right or left chest  

2. In the disposable CDS do you think that the high negativity relief valve should be :

Manual
Automatic
  

3. In the disposable CDS do you think that the high positive pressure relief valve should be:

Manual
Automatic
Both

4. In the disposable CDS do you think that a sterilizing membrane (between the fluid collection chamber and the water seal) * is

necessary
useful
useless

* A sterilizing membrane has the purpose to prevent the intake of non sterile air into the drainage circuit and the outflow of biological fluids from the collection chamber

Figure 5. Sterilizing membrane in CDS disposable.

5. In the disposable CDS do you think that a sequential tube clamp system (FIG 6 )for temporarily closing aspiration and  for preventing errors in manually venting high intrathoracic negative pressures is :

necessary
useful
useless

Figure 6. 

A sequential tube clamp system allows simultaneously to clamp the drainage connection tube, close the vacuum source , vent air into the fluid collection chamber

6. The air leakage is better evidenced by  :

CDS
One/Two bottles
Same with both systems

7. In the disposable CDS do you think that an air leakage scale is  :

necessary
useful
useless

8. In the disposable CDS with dry suction do you think that the suction control dial should select   :

-20 suction
0,-10,-20.-30,-40 suction
0,-20,-40 suction

9. In your wards how often the patient’s CDS is tipped over    :

never
seldom
often

10. In your opinion what is the minimal suction source (vacuum) power (liters per minute, LPM)    :

10 LPM
15 LPM
18 LPM
20 LPM

11. In your opinion what is the maximal suction source (vacuum ) power (liters per minute , LPM)   :

30 LPM
40 LPM
Other    LPM

12. Do you think that a CDS which automatically sets the level of suction according to the air leak rate is   :

necessary
useful
useless

Section 5 . Pneumonectomy

1. After pneumonectomy what do you do routinely :

use a pneumonectomy balanced drainage system
periodical thoracocentesis
Other  
 

Section 6 . Ambulatory drainage and suction

1. In the presence of a persistant (3-7 days) or large (>7 days) air leak what do you prefer:

keep the patient in bed with continuous suction
mobilise the patient with his standard CDS and operate suction when he returns to bed
to mobilise the patient with a waterless fixed suction (-20) device
to mobilise the patient with a chest drain valve
to mobilise the patient with a standard CDS connected with a portable (15-17 LPM) battery operated suction source

2. In the presence of a persistant minor (<3days) air leak what do you prefer:

keep the patient in bed with continuous suction
mobilise the patient with his standard CDS and operate suction when he returns to bed
to mobilise the patient with a waterless fixed suction (-20) device
to mobilise the patient with a chest drain valve
to mobilise the patient with a standard CDS connected with a portable (15-17 LPM) battery operated suction source

Section 7 . Assesment of CDS

1. Which is the worst feature of the system which you use currently (your answer in section 3)

2. What is the best feature which lead to your chooosing your current CDS?

3. Which are the standard duration of duration and maintenance of CDS in your centre:

	Major Lung Resection	Wedge resection	VATS	Pneumothorax Surgery	Oesophageal Cancer Surgery	Empyema
Stop suction and gravity drainage	PODay	PODay	PODay	PODay	PODay	PODay
Remove drains	PODay	PODay	PODay	PODay	PODay	PODay