Novel Split Chest Tube Improves Post-Surgical Thoracic Drainage
|Albert H Olivencia-Yurvati1,3*, Brandon H Cherry2,3, Hunaid A Gurji2,3, Daniel W White2,3, J Tyler Newton1, Gary F Scott2,3,
Besim Hoxha1, Terence Gourlay4 and Robert T Mallet1,2,3
|1Departments of Surgery, University of North Texas Health Science Center, Fort Worth, TX, USA|
|2Departments of Integrative Physiology, University of North Texas Health Science Center, Fort Worth, TX, USA|
|3Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA|
|4Bioengineering Unit, Wolfson Centre, University of Strathclyde, Glasgow, UK|
|Corresponding Author :||Albert H Olivencia-Yurvati
Department of Surgery, University of North Texas Health Science Center
3500 Camp Bowie Blvd., Fort Worth, TX 76107-2699, USA
Email: [email protected]
|Received May 16, 2014; Accepted June 23, 2014; Published June 30, 2014|
|Citation: Olivencia-Yurvati AH, Cherry BH, Gurji HA, White DW, Newton JT, et al. (2014) Novel Split Chest Tube Improves Post-Surgical Thoracic Drainage. J Clin Exp Cardiolog 5:321. doi:10.4172/2155-9880.1000321|
|Copyright: © 2014 Olivencia-Yurvati AH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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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 costo-diaphragmatic 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.