The gravity of this complication may outweigh any risk from disconnection, especially when good management should make sure that all connections are secure. The impression was that this practice had died out some time ago. A variety of instructions for patients are recommended, and again, there is no trend over time for this advice. There is no indication of where these different schools of thought originate, and little useful discussion as to the principles behind each technique. Weighing up the evidence for practice is interesting.
Several questions arise.
The systematic element of the study has hardly begun so the review is not complete. Let us assume for now that the basic details remain the same. The evidence presented here suggests that there are many different ways of managing aspects of care of the patient with a chest drain. As some are directly contradictory, common sense suggests they cannot all be right. The difference between evidence and research becomes clearer.