A pleural vacuum relief device for pleural drain unit use in the hyperbaric environment

Area of Science:

• Medical Devices
• Hyperbaric Medicine
• Pulmonary Physiology

Background:

• Standard pleural drain units (PDUs) can induce excessive negative intrapleural pressure (IPP) and fluid reflux under hyperbaric conditions, posing risks.
• This can lead to significant patient morbidity and limit hyperbaric treatment protocols.

Purpose of the Study:

• To develop and evaluate a pleural vacuum relief (PVR) device to manage risks associated with PDUs under hyperbaric conditions.
• To assess the PVR device's ability to allow more rapid hyperbaric pressure change rates.

Main Methods:

• A custom PVR device with a one-way pressure relief valve and micro filter was designed.
• The PVR device was connected to a standard Pleur-Evac A-6000 intercostal drain.
• Simulated IPP was measured with and without the PVR device at various suction levels and compression rates.

Main Results:

• Without the PVR device, excessive negative IPP (>10 kPa·min⁻¹) caused backflow through the PDU water seal.
• With the PVR device, negative IPP remained clinically acceptable, enabling compression rates of at least 30 kPa·min⁻¹.
• The PVR device allowed suction settings up to -20 cmH₂O during all hyperbaric treatment phases.

Conclusions:

• The developed PDU PVR device effectively minimizes risks of excessive negative IPP during hyperbaric therapy.
• The device reduces attendant workload and allows for faster hyperbaric pressure changes.
• The PVR device should be used with suction for optimal performance.