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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.
Flow rates achieved at various water pressure suction levels for the PDCs tested appear in Table 2. Reading here

These data may be summarized in five major points: (1) the highest flow rate at all negative pressures is seen with the Cook 24F chest tube; (2) at all pressures, the 14F Arrow drainage catheters had statistically greater flow rates than both the 16F and 14F Cook catheters (approximately 2 L/min and 4 L/min greater, respectively, at — 20 cm H2O); (3) the majority of catheters (6 of 11 catheters) at all suction levels tested (— 10 cm H2O, — 20 cm H2O, and — 40 cm H2O) have flow rates < 16 L/min; (4) at — 20 cm H2O (an often-used level of suction pressure in clinical practice), only three catheters (Arrow 14F AK-01600, Arrow 14F AK-01601, and Cook 24F C-TQTS-2400) had flow rates > 16 L/min; and (5) the lowest mean flow rates are seen in the two catheters with three-way stopcocks (Argyle Safety Thoracentesis and Arrow AK-01000 Pleural-seal Thoracentesis kit).
Discussion
Chest tube placement and subsequent connection to a PDU may be appropriate for many pneumothoraces. The settings appropriate for chest tube placement, the size of tube selected, including smaller-bore tubes, and subsequent utilization of a PDU are well outlined for spontaneous pneumothoraces in the recent ACCP spontaneous pneumothorax consensus statement.