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Comparison of function of commercially available pleural drainage units and catheters
Michael H Baumann1, Praful B Patel, Chris W Roney
1Division of Pulmonary and Critical Care Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA. mbaumann@medicine.umsmed.edu
Purpose:
Flow rates and pressures generated by commercially available pleural drainage units (PDUs) and flow rates through available pleural drainage catheters (PDCs) are not known. This information may be important clinically depending on the volume of air leak associated with a bronchopleural fistula.
Design:
Eight PDUs were assessed for flow rates at various suction levels and for the percent accuracy of suction pressures generated at various settings. Eleven commonly used PDCs were assessed for flow rates at various suction control levels. All devices were donated by their manufacturer. Flow rates and pressures were measured by a RT 200 Calibration Analyzer (Timeter Instrument Corporation; St. Louis, MO) at body temperature, ambient pressure, saturated with water vapor. Five devices of each type were tested. Analysis of variance was performed with p < 0.05 being significant.
Results:
Multiple significant differences between PDUs were noted at a pressure of - 20 cm H(2)O. The Argyle Sentinel Seal (Sherwood Medical; Tillamore, Ireland) had significantly lower flow rates (mean +/- SD, 10.8 +/- 0.6 L/min) compared with all other models. The Argyle Aqua-Seal (Sherwood Medical) had the highest PDU flow rate of devices tested (42.1 +/- 1.0 L/min). The accuracy of PDUs at manufacturer-suggested settings varied from a mean percentage error of 0.0 to 15.5% from expected pressures; significant differences were noted in accuracy among multiple interdevice pressure comparisons. Similarly, multiple significant flow rate differences between PDCs were noted at - 20 cm H(2)O. Lowest flow rates were noted with thoracentesis catheters (used as PDCs) containing side ports. Arrow drainage catheters (14F, pigtail and straight) [Arrow International; Reading, PA] both had significantly greater flow rates (both, 16.8 +/- 0.1 L/min), compared with the 14F (12.8 +/- 0.3) and 16F (14.8 +/- 0.6) Cook devices (Cook; Bloomington, IN).
Conclusions:
These differences in flow rates for PDUs and PDCs may be clinically important, particularly in patients with large pneumothorax-related air leaks. Observed differences in PDU-generated pressures are likely not clinically important.