Chih-Hao Chen1, Tsang-Pai Liu1, Ho Chang1, Tung-Sung Huang1, Hung-Chang Liu1, Chao-Hung Chen1. 1. 1 Department of Medicine, Mackay Medical College, New Taipei City, Taiwan ; 2 Department of Thoracic Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 3 Mackay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan ; 4 Department of General Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 5 Graduate Institute of Manufacturing Technology, National Taipei University of Technology, Taipei 10608, Taiwan.
Abstract
BACKGROUND: Tube thoracostomy is a common procedure. A chest bottle may be used to both collect fluids and monitor the recovery of the chest condition. The presence of the "tidaling phenomenon" in the bottle can be reflective of the extent of patient's recovery. OBJECTIVES: However, current practice essentially depends on gross observation of the bottle. The device used here is designed for a real-time monitoring of change in pleural pressure to allow clinicians to objectively determine when the lung has recovered, which is crucially important in order to judge when to remove the chest tube. METHODS: The device is made of a pressure sensor with an operating range between -100 to +100 cmH2O and an amplifying using the "Wheatstone bridge" concept. Recording and analysis was performed with LABview software. The data can be shown in real-time on screen and also be checked retrospectively. The device was connected to the second part of a three-bottle drain system by a three-way connector. RESULTS: The test animals were two 40-kg pigs. We used a thoracoscopic procedure to create an artificial lung laceration with endoscopic scissors. Active air leaks could result in vigorous tidaling phenomenon up to 20 cmH2O. In the absence of gross tidaling phenomenon, the pressure changes were around 0.25 cmH2O. CONCLUSIONS: This real-time pleural pressure monitoring device can help clinicians objectively judge the extent of recovery of the chest condition. It can be used as an effective adjunct with the current chest drain system.
BACKGROUND: Tube thoracostomy is a common procedure. A chest bottle may be used to both collect fluids and monitor the recovery of the chest condition. The presence of the "tidaling phenomenon" in the bottle can be reflective of the extent of patient's recovery. OBJECTIVES: However, current practice essentially depends on gross observation of the bottle. The device used here is designed for a real-time monitoring of change in pleural pressure to allow clinicians to objectively determine when the lung has recovered, which is crucially important in order to judge when to remove the chest tube. METHODS: The device is made of a pressure sensor with an operating range between -100 to +100 cmH2O and an amplifying using the "Wheatstone bridge" concept. Recording and analysis was performed with LABview software. The data can be shown in real-time on screen and also be checked retrospectively. The device was connected to the second part of a three-bottle drain system by a three-way connector. RESULTS: The test animals were two 40-kg pigs. We used a thoracoscopic procedure to create an artificial lung laceration with endoscopic scissors. Active air leaks could result in vigorous tidaling phenomenon up to 20 cmH2O. In the absence of gross tidaling phenomenon, the pressure changes were around 0.25 cmH2O. CONCLUSIONS: This real-time pleural pressure monitoring device can help clinicians objectively judge the extent of recovery of the chest condition. It can be used as an effective adjunct with the current chest drain system.
Authors: Aaron R Casha; Roberto Caruana-Gauci; Alexander Manche; Marilyn Gauci; Stanley Chetcuti; Luca Bertolaccini; Marco Scarci Journal: J Thorac Dis Date: 2017-04 Impact factor: 2.895