Novel split chest tube improves post-surgical thoracic drainage

Albert Yurvati, Brandon H. Cherry, Hunaid A. Gurji, Daniel W. White, J. Tyler Newton, Gary F. Scott, Besim Hoxha, Terence Gourlay, Robert T. Mallet

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: Conventional, separate mediastinal and pleural tubes are often inefficient at draining thoracic effusions. Description: We developed a Y-shaped chest tube with split ends that divide within the thoracic cavity, permitting separate intrathoracic placement and requiring a single exit port. In this study, thoracic drainage by the split drain vs. that of separate drains was tested. Methods: After sternotomy, pericardiotomy, and left pleurotomy, pigs were fitted with separate chest drains (n=10) or a split tube prototype (n=9) with internal openings positioned in the mediastinum and in the costodiaphragmatic recess. Separate series of experiments were conducted to test drainage of D5W or 0.58 M sucrose, an aqueous solution with viscosity approximating that of plasma. One litre of fluid was infused into the thorax, and suction was applied at -20 cm H2O for 30 min. Results: When D5W was infused, the split drain left a residual volume of 53±99 ml (mean value ± SD) vs. 148 ± 120 for the separate drain (P = 0.007), representing a drainage efficiency (i.e. drained vol/[drained + residual vol]) of 95 ± 10% vs. 86 ± 12% for the separate drains (P = 0.011). In the second series, the split drain evacuated more 0.58 M sucrose in the first minute (967 ± 129 ml) than the separate drains (680 ± 192 ml, P<0.001). By 30 min, the split drain evacuated a similar volume of sucrose vs. the conventional drain (1089 ± 72 vs. 1056 ± 78 ml; P = 0.5). Residual volume tended to be lower (25 ± 10 vs. 62 ± 72 ml; P = 0.128) and drainage efficiency tended to be higher (98 ± 1 vs. 95 ± 6%; P = 0.111) with the split drain vs. conventional separate drains. Conclusion: The split chest tube drained the thoracic cavity at least as effectively as conventional separate tubes. This new device could potentially alleviate postoperative complications.

Original languageEnglish
JournalJournal of Clinical and Experimental Cardiology
Volume5
Issue number7
DOIs
StatePublished - 1 Jan 2014

Fingerprint

Chest Tubes
Drainage
Thorax
Thoracic Cavity
Sucrose
Residual Volume
Pericardiectomy
Sternotomy
Suction
Mediastinum
Viscosity
Swine
Equipment and Supplies

Keywords

  • Chest
  • Pleural effusion
  • Pleural space
  • Surgical equipment
  • Thoracotomy

Cite this

Yurvati, Albert ; Cherry, Brandon H. ; Gurji, Hunaid A. ; White, Daniel W. ; Tyler Newton, J. ; Scott, Gary F. ; Hoxha, Besim ; Gourlay, Terence ; Mallet, Robert T. / Novel split chest tube improves post-surgical thoracic drainage. In: Journal of Clinical and Experimental Cardiology. 2014 ; Vol. 5, No. 7.
@article{8c850bb979894efcba2934b4db2ecc3a,
title = "Novel split chest tube improves post-surgical thoracic drainage",
abstract = "Objective: Conventional, separate mediastinal and pleural tubes are often inefficient at draining thoracic effusions. Description: We developed a Y-shaped chest tube with split ends that divide within the thoracic cavity, permitting separate intrathoracic placement and requiring a single exit port. In this study, thoracic drainage by the split drain vs. that of separate drains was tested. Methods: After sternotomy, pericardiotomy, and left pleurotomy, pigs were fitted with separate chest drains (n=10) or a split tube prototype (n=9) with internal openings positioned in the mediastinum and in the costodiaphragmatic recess. Separate series of experiments were conducted to test drainage of D5W or 0.58 M sucrose, an aqueous solution with viscosity approximating that of plasma. One litre of fluid was infused into the thorax, and suction was applied at -20 cm H2O for 30 min. Results: When D5W was infused, the split drain left a residual volume of 53±99 ml (mean value ± SD) vs. 148 ± 120 for the separate drain (P = 0.007), representing a drainage efficiency (i.e. drained vol/[drained + residual vol]) of 95 ± 10{\%} vs. 86 ± 12{\%} for the separate drains (P = 0.011). In the second series, the split drain evacuated more 0.58 M sucrose in the first minute (967 ± 129 ml) than the separate drains (680 ± 192 ml, P<0.001). By 30 min, the split drain evacuated a similar volume of sucrose vs. the conventional drain (1089 ± 72 vs. 1056 ± 78 ml; P = 0.5). Residual volume tended to be lower (25 ± 10 vs. 62 ± 72 ml; P = 0.128) and drainage efficiency tended to be higher (98 ± 1 vs. 95 ± 6{\%}; P = 0.111) with the split drain vs. conventional separate drains. Conclusion: The split chest tube drained the thoracic cavity at least as effectively as conventional separate tubes. This new device could potentially alleviate postoperative complications.",
keywords = "Chest, Pleural effusion, Pleural space, Surgical equipment, Thoracotomy",
author = "Albert Yurvati and Cherry, {Brandon H.} and Gurji, {Hunaid A.} and White, {Daniel W.} and {Tyler Newton}, J. and Scott, {Gary F.} and Besim Hoxha and Terence Gourlay and Mallet, {Robert T.}",
year = "2014",
month = "1",
day = "1",
doi = "10.4172/2155-9880.1000321",
language = "English",
volume = "5",
journal = "Journal of Clinical and Experimental Cardiology",
issn = "2155-9880",
publisher = "OMICS Publishing Group",
number = "7",

}

Novel split chest tube improves post-surgical thoracic drainage. / Yurvati, Albert; Cherry, Brandon H.; Gurji, Hunaid A.; White, Daniel W.; Tyler Newton, J.; Scott, Gary F.; Hoxha, Besim; Gourlay, Terence; Mallet, Robert T.

In: Journal of Clinical and Experimental Cardiology, Vol. 5, No. 7, 01.01.2014.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Novel split chest tube improves post-surgical thoracic drainage

AU - Yurvati, Albert

AU - Cherry, Brandon H.

AU - Gurji, Hunaid A.

AU - White, Daniel W.

AU - Tyler Newton, J.

AU - Scott, Gary F.

AU - Hoxha, Besim

AU - Gourlay, Terence

AU - Mallet, Robert T.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objective: Conventional, separate mediastinal and pleural tubes are often inefficient at draining thoracic effusions. Description: We developed a Y-shaped chest tube with split ends that divide within the thoracic cavity, permitting separate intrathoracic placement and requiring a single exit port. In this study, thoracic drainage by the split drain vs. that of separate drains was tested. Methods: After sternotomy, pericardiotomy, and left pleurotomy, pigs were fitted with separate chest drains (n=10) or a split tube prototype (n=9) with internal openings positioned in the mediastinum and in the costodiaphragmatic recess. Separate series of experiments were conducted to test drainage of D5W or 0.58 M sucrose, an aqueous solution with viscosity approximating that of plasma. One litre of fluid was infused into the thorax, and suction was applied at -20 cm H2O for 30 min. Results: When D5W was infused, the split drain left a residual volume of 53±99 ml (mean value ± SD) vs. 148 ± 120 for the separate drain (P = 0.007), representing a drainage efficiency (i.e. drained vol/[drained + residual vol]) of 95 ± 10% vs. 86 ± 12% for the separate drains (P = 0.011). In the second series, the split drain evacuated more 0.58 M sucrose in the first minute (967 ± 129 ml) than the separate drains (680 ± 192 ml, P<0.001). By 30 min, the split drain evacuated a similar volume of sucrose vs. the conventional drain (1089 ± 72 vs. 1056 ± 78 ml; P = 0.5). Residual volume tended to be lower (25 ± 10 vs. 62 ± 72 ml; P = 0.128) and drainage efficiency tended to be higher (98 ± 1 vs. 95 ± 6%; P = 0.111) with the split drain vs. conventional separate drains. Conclusion: The split chest tube drained the thoracic cavity at least as effectively as conventional separate tubes. This new device could potentially alleviate postoperative complications.

AB - Objective: Conventional, separate mediastinal and pleural tubes are often inefficient at draining thoracic effusions. Description: We developed a Y-shaped chest tube with split ends that divide within the thoracic cavity, permitting separate intrathoracic placement and requiring a single exit port. In this study, thoracic drainage by the split drain vs. that of separate drains was tested. Methods: After sternotomy, pericardiotomy, and left pleurotomy, pigs were fitted with separate chest drains (n=10) or a split tube prototype (n=9) with internal openings positioned in the mediastinum and in the costodiaphragmatic recess. Separate series of experiments were conducted to test drainage of D5W or 0.58 M sucrose, an aqueous solution with viscosity approximating that of plasma. One litre of fluid was infused into the thorax, and suction was applied at -20 cm H2O for 30 min. Results: When D5W was infused, the split drain left a residual volume of 53±99 ml (mean value ± SD) vs. 148 ± 120 for the separate drain (P = 0.007), representing a drainage efficiency (i.e. drained vol/[drained + residual vol]) of 95 ± 10% vs. 86 ± 12% for the separate drains (P = 0.011). In the second series, the split drain evacuated more 0.58 M sucrose in the first minute (967 ± 129 ml) than the separate drains (680 ± 192 ml, P<0.001). By 30 min, the split drain evacuated a similar volume of sucrose vs. the conventional drain (1089 ± 72 vs. 1056 ± 78 ml; P = 0.5). Residual volume tended to be lower (25 ± 10 vs. 62 ± 72 ml; P = 0.128) and drainage efficiency tended to be higher (98 ± 1 vs. 95 ± 6%; P = 0.111) with the split drain vs. conventional separate drains. Conclusion: The split chest tube drained the thoracic cavity at least as effectively as conventional separate tubes. This new device could potentially alleviate postoperative complications.

KW - Chest

KW - Pleural effusion

KW - Pleural space

KW - Surgical equipment

KW - Thoracotomy

UR - http://www.scopus.com/inward/record.url?scp=84907362938&partnerID=8YFLogxK

U2 - 10.4172/2155-9880.1000321

DO - 10.4172/2155-9880.1000321

M3 - Article

VL - 5

JO - Journal of Clinical and Experimental Cardiology

JF - Journal of Clinical and Experimental Cardiology

SN - 2155-9880

IS - 7

ER -