Utilização da válvula unidirecional de tórax como sistema de drenagem no pós-operatório de ressecções pulmonares

Abstract

The conventional system of pleural drainage currently in use in the treatment of pleural diseases and in the postoperative period following thoracic surgery is the same as that described by Kenyon in 1916. (1) This method consists IntroductionAfter any surgical procedure involving the opening of the pleura, the thoracic cavity must be drained in order to facilitate adequate pulmonary reexpansion and allow the outflow of blood, fluids and air.Use of a one-way flutter valve drainage system in the postoperative period following lung resection* Objective: To evaluate pleural drainage using a one-way flutter valve following elective lung resection. Methods: This was a prospective study, with descriptive analysis, of 39 lung resections performed using a one-way flutter valve to achieve pleural drainage during the postoperative period. Patients less than 12 years of age were excluded, as were those submitted to pneumonectomy or emergency surgery, those who were considered lost to follow-up and those in whom water-seal drainage was used as the initial method of pleural drainage. Lung expansion, duration of the drainage, hospital stay and postoperative complications were noted. Results: A total of 36 patients were included and analyzed in this study. The mean duration of pleural drainage was 3.0 ± 1.6 days. At 30 days after the surgical procedure, chest X-ray results were considered normal for 34 patients (95.2%). Postoperative complications occurred in 8 patients (22.4%) and were related to the drainage system in 3 (8.4%) of those. Conclusions: The use of a one-way flutter valve following elective lung resection was effective, was well tolerated and presented a low rate of complications.

Practical Aspects About Closed Chest Drainage Care: A Literature Review

“…Nonetheless, the purpose of the system is to allow for drainage from the pleural cavity to the outside and at the same time prevent the entry of atmospheric air into the pleural cavity. The chest drainage also aims to maintain or restore the negative pressure of the pleural space [2][3][4]12,16,18,20 . For each case, there are 3 types of chest drainage systems for pleura effusion: (i) the closed drainage system; (ii) the open drainage system; and (iii) the suction drainage system [7][8][9][10][11][12][13][14][15][16][17][18][20][21][22] .…”

“…Chest tubes are multifenestrated, e.g. have several openings at one end of the tube section (which resides inside the patient wall) and have a rounded end 3,12 . Nontheless, chest tubes are placed on a superior position for air removal (tube placed high) and placed on an inferior position, primarily for fluid removal (tube placed low) 1,2,4,12 .…”

“…Then, the more positive pressure makes the sleeve opens, allowing their contain to escape. (Figure 3D left) During inspiration, the parietal pleural portion follows the chest wall traction and intrapleural pressure becomes more negative, making sleeve closes, which prevents backflow of air ( Figure 3D right) 3,4,15,22 . This kind of drainage works independently on the gravidity.…”

“…Ideally, a closed system decreases infection risk and restore the negative pressure of the pleural space 2,3,4 .…”

Dysfunctional Closed Chest Drainage - Common Causative Factors and Recommendations for Prevention

“…They should be directed to keep the CDUs below the level of the chest. The flutter valve systems may be used in patients who are stable with mild air and fluid leak from the TT [ 16 ]. Only sterile 0.9% saline solution should be used as the prime fluid in the underwater seal bottles.…”