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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). Conceivably, these differences may also be accounted for by differences in the catheter bore size not reflected by the sizes reported by the manufacturers. Lastly, different PDC construction materials may be more or less collapsible under negative pressure. Ease of collapse would be particularly important in the patient where tissues surrounding the PDC could also drive collapse. PDC collapsibil-ity and its affect on air flow were not assessed. Regardless, differences in air flow rates may not be recognized by a clinician selecting a catheter simply based on bore size.
Lastly, using PDC equipment designed as thoracentesis equipment for pneumothorax management may not be a wise choice. Such issues are becoming more prevalent in a cost-containment environment when attempting to purchase one device to meet multiple clinical needs. Both the Argyle and Arrow thoracentesis PDCs have clinically significant less air flow rates compared to their comparable pneumothorax PDCs despite the same bore (each 8F) and the lowest flow rates of all PDCs tested at all tested pressure settings (Table 2). The Argyle thoracentesis PDC accommodates less than half the flow of the comparable Argyle pneumothorax PDC, and the Arrow thoracentesis PDC handles approximately 1.5 L/min less flow than the comparable Arrow pneumothorax PDC (all tests at — 20 cm H2O).