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Novel Split Chest Tube Improves Post-Surgical Thoracic Drainage.

Olivencia-Yurvati AH, Cherry BH, Gurji HA, White DW, Newton JT, Scott GF, Hoxha B, Gourlay T, Mallet RT - J Clin Exp Cardiolog (2014)

Bottom Line: By 30 min, the split drain evacuated a similar volume of sucrose vs. the conventional drain (1089 ± 72 vs. 1056 ± 78 ml; P = 0.5).The split chest tube drained the thoracic cavity at least as effectively as conventional separate tubes.This new device could potentially alleviate postoperative complications.

View Article: PubMed Central - HTML - PubMed

Affiliation: Departments of Surgery, University of North Texas Health Science Center, Fort Worth, TX, USA ; Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA.

ABSTRACT

Objective: Conventional, separate mediastinal and pleural tubes are often inefficient at draining thoracic effusions.

Description: We developed a Y-shaped chest tube with split ends that divide within the thoracic cavity, permitting separate intrathoracic placement and requiring a single exit port. In this study, thoracic drainage by the split drain vs. that of separate drains was tested.

Methods: After sternotomy, pericardiotomy, and left pleurotomy, pigs were fitted with separate chest drains (n=10) or a split tube prototype (n=9) with internal openings positioned in the mediastinum and in the costo-diaphragmatic recess. Separate series of experiments were conducted to test drainage of D5W or 0.58 M sucrose, an aqueous solution with viscosity approximating that of plasma. One litre of fluid was infused into the thorax, and suction was applied at -20 cm H2O for 30 min.

Results: When D5W was infused, the split drain left a residual volume of 53 ± 99 ml (mean value ± SD) vs. 148 ± 120 for the separate drain (P=0.007), representing a drainage efficiency (i.e. drained vol/[drained + residual vol]) of 95 ± 10% vs. 86 ± 12% for the separate drains (P = 0.011). In the second series, the split drain evacuated more 0.58 M sucrose in the first minute (967 ± 129 ml) than the separate drains (680 ± 192 ml, P<0.001). By 30 min, the split drain evacuated a similar volume of sucrose vs. the conventional drain (1089 ± 72 vs. 1056 ± 78 ml; P = 0.5). Residual volume tended to be lower (25 ± 10 vs. 62 ± 72 ml; P = 0.128) and drainage efficiency tended to be higher (98 ± 1 vs. 95 ± 6%; P = 0.111) with the split drain vs. conventional separate drains.

Conclusion: The split chest tube drained the thoracic cavity at least as effectively as conventional separate tubes. This new device could potentially alleviate postoperative complications.

No MeSH data available.


Related in: MedlinePlus

Thoracic placement of conventional drainage tubes (A, B) and prototype split chest drain (C, D). Panels A and C show placement of drainage tubes within the thoracic cavity. Blue arrows: catheter for sucrose infusion; green arrows: mediastinal drain; yellow arrows: pleural drain in the costo-diaphragmatic recess. Panels B and D show the exit incisions (red arrows) for the drainage tubes after closure of the thorax.
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Figure 2: Thoracic placement of conventional drainage tubes (A, B) and prototype split chest drain (C, D). Panels A and C show placement of drainage tubes within the thoracic cavity. Blue arrows: catheter for sucrose infusion; green arrows: mediastinal drain; yellow arrows: pleural drain in the costo-diaphragmatic recess. Panels B and D show the exit incisions (red arrows) for the drainage tubes after closure of the thorax.

Mentions: Each pig underwent a median sternotomy, pericardiotomy, and left pleurotomy. Next, chest tubes were inserted into the thoracic cavity. A 3 cm incision was made on the skin, a Schnidt clamp was used for blunt dissection and to secure and exteriorize the drainage catheter via the incision, and the catheter was secured at the incision with a purse string suture (Figure 2B, D: red arrows). In the conventional drainage configuration, two separate tubes were positioned in the mediastinum (Figure 2A: green arrow) and within the costo-diaphragmatic recess (Figure 2A: yellow arrow). In the split drain configuration, the tubing was divided, the intrathoracic ends positioned to drain the mediastinum (Figure 2C: green arrow) and costo-diaphragmatic recess (Figure 2C: yellow arrow), and the common end exteriorized through the parasternal angle.


Novel Split Chest Tube Improves Post-Surgical Thoracic Drainage.

Olivencia-Yurvati AH, Cherry BH, Gurji HA, White DW, Newton JT, Scott GF, Hoxha B, Gourlay T, Mallet RT - J Clin Exp Cardiolog (2014)

Thoracic placement of conventional drainage tubes (A, B) and prototype split chest drain (C, D). Panels A and C show placement of drainage tubes within the thoracic cavity. Blue arrows: catheter for sucrose infusion; green arrows: mediastinal drain; yellow arrows: pleural drain in the costo-diaphragmatic recess. Panels B and D show the exit incisions (red arrows) for the drainage tubes after closure of the thorax.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4251778&req=5

Figure 2: Thoracic placement of conventional drainage tubes (A, B) and prototype split chest drain (C, D). Panels A and C show placement of drainage tubes within the thoracic cavity. Blue arrows: catheter for sucrose infusion; green arrows: mediastinal drain; yellow arrows: pleural drain in the costo-diaphragmatic recess. Panels B and D show the exit incisions (red arrows) for the drainage tubes after closure of the thorax.
Mentions: Each pig underwent a median sternotomy, pericardiotomy, and left pleurotomy. Next, chest tubes were inserted into the thoracic cavity. A 3 cm incision was made on the skin, a Schnidt clamp was used for blunt dissection and to secure and exteriorize the drainage catheter via the incision, and the catheter was secured at the incision with a purse string suture (Figure 2B, D: red arrows). In the conventional drainage configuration, two separate tubes were positioned in the mediastinum (Figure 2A: green arrow) and within the costo-diaphragmatic recess (Figure 2A: yellow arrow). In the split drain configuration, the tubing was divided, the intrathoracic ends positioned to drain the mediastinum (Figure 2C: green arrow) and costo-diaphragmatic recess (Figure 2C: yellow arrow), and the common end exteriorized through the parasternal angle.

Bottom Line: By 30 min, the split drain evacuated a similar volume of sucrose vs. the conventional drain (1089 ± 72 vs. 1056 ± 78 ml; P = 0.5).The split chest tube drained the thoracic cavity at least as effectively as conventional separate tubes.This new device could potentially alleviate postoperative complications.

View Article: PubMed Central - HTML - PubMed

Affiliation: Departments of Surgery, University of North Texas Health Science Center, Fort Worth, TX, USA ; Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA.

ABSTRACT

Objective: Conventional, separate mediastinal and pleural tubes are often inefficient at draining thoracic effusions.

Description: We developed a Y-shaped chest tube with split ends that divide within the thoracic cavity, permitting separate intrathoracic placement and requiring a single exit port. In this study, thoracic drainage by the split drain vs. that of separate drains was tested.

Methods: After sternotomy, pericardiotomy, and left pleurotomy, pigs were fitted with separate chest drains (n=10) or a split tube prototype (n=9) with internal openings positioned in the mediastinum and in the costo-diaphragmatic recess. Separate series of experiments were conducted to test drainage of D5W or 0.58 M sucrose, an aqueous solution with viscosity approximating that of plasma. One litre of fluid was infused into the thorax, and suction was applied at -20 cm H2O for 30 min.

Results: When D5W was infused, the split drain left a residual volume of 53 ± 99 ml (mean value ± SD) vs. 148 ± 120 for the separate drain (P=0.007), representing a drainage efficiency (i.e. drained vol/[drained + residual vol]) of 95 ± 10% vs. 86 ± 12% for the separate drains (P = 0.011). In the second series, the split drain evacuated more 0.58 M sucrose in the first minute (967 ± 129 ml) than the separate drains (680 ± 192 ml, P<0.001). By 30 min, the split drain evacuated a similar volume of sucrose vs. the conventional drain (1089 ± 72 vs. 1056 ± 78 ml; P = 0.5). Residual volume tended to be lower (25 ± 10 vs. 62 ± 72 ml; P = 0.128) and drainage efficiency tended to be higher (98 ± 1 vs. 95 ± 6%; P = 0.111) with the split drain vs. conventional separate drains.

Conclusion: The split chest tube drained the thoracic cavity at least as effectively as conventional separate tubes. This new device could potentially alleviate postoperative complications.

No MeSH data available.


Related in: MedlinePlus