#Pleur evac simulator
To test the CDUs, a pleural space environment simulator was built ( Figure 1a). A paradigm shift to better understand all components of pleural physiology post-surgical intervention on this relatively neglected topic is needed to improve our daily practice. This sounds the call to tailor our clinical practice for the individual patient. Conclusions: Different chest drainage unit designs lead to different performances, some of which may negatively impact patient outcomes. Only seven dry-suction units were able to maintain the set suction at high airflow rates (>20 L/min). Ten wet and five dry-dry units showed no capability to handle a 10 L/min leak, as they were restrictive to flow (peak pressure up to 55 cmH 2O). Ten wet units showed no automatic negative pressure relief features, while five dry-dry did but were slow to react. Results: All wet units showed reverse air flow, with the potential to mimic an air leak when there was none. According to the design of the seal and of the suction control, the units were classified as wet-wet, wet-dry and dry-dry. Twenty-five units were “traditional” thoracic drainages, five were “digital” low-flow/low-vacuum pumps and two were hybrids (a combination of the two). Thirty-two units were tested under four clinical scenarios: air leak interpretation during quiet breathing and after obstructed inspiration (−5 to −150 cmH 2O), a buildup of negative pressure (−100 cmH 2O), a bronchopleural fistula (10 L/min) and the need for effective external suction in the presence of air leakage. Methods: A pleural space environment simulator was built. Thus, we sought to test the performance of the most commonly used chest drainage units under conditions that are relevant to clinical practice. Clinicians are now surrounded by a plethora of different types of systems, but little is known about the way that they work and perform.
Background: Over the last 100 years, the original three-bottle chest drainage system has been variously engineered into compact disposables and electronic units.
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