Category Archives: Pleural

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Conclusion

All other PDU models demonstrated significant pressure accuracy error differences between the two external suction settings (manufacturer-suggested wall suction setting vs full wall suction) in the negative direction (delivering more negative pressure than the PDU test value). The least accurate PDU at full wall suction was the Thora-Seal III, with a mean error of 27%. This translates to a mean delivered negative water pressure of 25.4 cm H2O.

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Lung and pericardium

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Lung and pericardiumThis means that the device actually delivers on average — 16.9 cm H2O (— 20 cm H2O less — 20 cm H2O multiplied by 15.5%). This decrease in delivered negative pressure is likely of little clinical significance given the mean flow rate delivered by the device (20.3 L/min, Table 1) at the set PDU pressure of — 20 cm H2O.

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Thoracentesis catheters

Interestingly, the lengths of both the Argyle and Arrow thoracentesis PDCs are shorter than their comparable pneumothorax catheter of the same internal bore (Table 2); shorter length should enhance not reduce flow rates. The lower flow rates of the thoracentesis catheters may be accounted for by the equipment attached proximally to the thoracentesis catheters including a three-way stopcock and a self-sealing valve.

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Arrow thoracentesis PDCs

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Arrow thoracentesis PDCsThe premise that larger-bore PDCs should provide larger flow rates breaks down when assessing the Cook 14F (C-UPTP-1400-WAYNE) and 16F (C-TQTS-1600) catheters compared with the Arrow 14F catheters (AK-01600 and AK-01601) [Table 2]. Based on the Fanning equation, the clinically significant, lower flow rates of the Cook 14F and 16F catheters at — 20 cm H2O (approximately 4 L/min and 2 L/min less, respectively) may be accounted for by their greater length (29 cm and 41 cm, respectively) compared to the Arrow 14F catheters (both 23 cm).

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Smaller-bore PDCs

This catheter had the highest flows at all pressures tested. Catheters < 16F may be considered small bore and deliver significantly less flow than the only larger-bore PDC tested, the Cook C-TQTS-2400. Various clinical conditions outlined above may have bronchopleural fistula flow rates of up to 16 L/min. The clinician, however, must be vigilant for air leaks > 16 L/min, as noted earlier. The Arrow AK-01600 and AK-01601 are the only two < 16F PDCs tested able to accommodate the arbitrary value of 16 L/min of flow at — 20 cm H2O.

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Smaller-bore chest tube

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Smaller-bore chest tubeThis problem is compounded by the absence of flow rate information in the packaging with either PDUs or PDCs. This absence of information leaves the clinician unable to compare flow characteristics of these devices and objectively choose the optimal device fitting the clinical situation. The absence of packaging information regarding the accuracy of pressures generated by PDUs further complicates the picture. These factors prompted the current study. http://buy-asthma-inhalers-online.com/ventolin-inhaler-100mcg-salbutamol.html

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Patient’s pleural space

Appropriate PDC size selection is therefore key to preventing tension pneumothorax development. Because a PDU is often connected in series with a PDC, appropriate PDU selection is also key. However, when considering flow rates accommodated, the PDC is the most likely rate-limiting device when compared to the PDU (Tables 1, 2).

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Discussion

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: DiscussionConsensus is less defined regarding chest tube utilization, tube size selection, and the role of PDUs in nonspontaneous pneumothoraces, but some evidence provides direction.
Key to the selection of a PDC and a PDU in the setting of both spontaneous and nonspontaneous pneumothoraces is the maximal air flow (the volume of air per unit of time) each device accommodates particularly if an air leak (bronchopleural fistula) persists. Gases leaked by a bronchopleural fistula are moist with turbulent flow characteristics. The Fanning equation determines the flow of moist gas with turbulent flow characteristics through a PDC (v = ^2rP/fl; v = flow, r = radius, l = length, P = pressure, f = friction factor).

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: PDC Assessment

Of the PDUs providing — 40 cm H2O settings (Table 1), the Pleur-evac A-6000 and Pleur-evac SAHARA produced similar accuracy (comparing same-model PDU to same-model PDU at the two different external suction settings). The Atrium 3600 and 3612 demonstrated significant pressure accuracy error differences between the two external suction settings in the negative direction (delivering more negative pressure than the PDU test value), with mean accuracy errors of 2.3% and 2.9%, respectively.

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Accurate pressures

Comparison of Function of Commercially Available Pleural Drainage Units and Catheters: Accurate pressuresThe Atrium 3612 was the least accurate PDU, demonstrating a mean error of 15.5%, with this accuracy being different from all other PDU models tested at — 20 cm H2O. The Sentinel Seal was the most accurate PDU, with a mean error of 0.0%, notably with manufacturer instructions necessitating wall suction being set at full vacuum. Accuracy of the other units was variable, but all devices had a mean error of < 10%. The errors of all of the PDUs were in the positive direction (delivering less negative pressure than the PDU test value) except for the Thora-Seal III, which demonstrated a mean error of 0.8% in the direction of increased negative pressure from the test (PDU set) value. canadian family pharmacy

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