A physiological comparison of flutter valve drainage bags and underwater seal systems for postoperative air leaks

Waller, David; Edwards, John; Rajesh, P.

doi:10.1136/thx.54.5.442

Cited by 16 publications

(16 citation statements)

References 5 publications

(4 reference statements)

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“…We have shown earlier that flutter valve drainage bag is a feasible method in the treatment of pneumothorax and pleural effusion (3). Furthermore, there is evidence that the flutter valve may provide a physiologically more effective alternative to the underwater seal drainage without suction in the treatment of persistent postoperative air leaks in the presence of an expanded lung (6). The present study on clinical benefits of flutter valve system for drainage after lung surgery shows, that there is no clinical difference in the duration of drainage and hospitalization in the surgical ward between the conventional underwater seal system and the flutter valve system.…”

Section: Discussionmentioning

confidence: 65%

“…The ambulatory chest drainage system has been designed as an alternative to the underwater seal system incorporating a re-entry preventing flut-ter valve and vented outlet into a flexible bag. This system has been designed for emergency situations, but its effectiveness has been shown also in treating postoperative air leaks after elective thoracotomy (4,6).…”

Section: Introductionmentioning

confidence: 99%

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Comparison between Flutter Valve Drainage Bag and Underwater Seal Device for Pleural Drainage after Lung Surgery

2005

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Aim of the study: The purpose of the present study was to compare the use of a conventional underwater seal device with suction and a flutter valve drainage bag for pleural drainage after lung surgery. Results: In the conventional underwater seal device group the mean drainage time was 2.6 (SD ± 2.0) days and in the flutter valve drainage bag group the mean drainage time was 3.3 days (SD ± 4.0); difference -0.8, 95% confidence interval (CI) -2.4 to 0.9. The mean length of hospitalization in the surgical ward was 3.6 (SD ± 2.7) and 4.1 (SD ± 4.4) days respectively (difference -0.5, 95% CI -2.5 to 1.4). Patients and MethodsConclusions: The results of this study suggest that flutter valve drainage system is a safe and feasible alternative in managing postoperative air leaks and haemorrhage after lung surgery other than pneumonectomy if air leaks are not extremely massive.

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Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Comparison between Flutter Valve Drainage Bag and Underwater Seal Device for Pleural Drainage after Lung Surgery

2005

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“…(3) Since then, interest in developing an alternative and adequate thoracic drainage system has been reported in the literature. (4,(6)(7)(8) The objective of this study was to evaluate pleural drainage using a one-way flutter valve in the postoperative period following elective lung resection. This valve is similar to the Heimlich valve and was developed in the Department of Thoracic Surgery at the Santa Casa de Misericórdia de Ribeirão Preto in 1988.…”

Section: Methodsmentioning

confidence: 99%

“…This system is efficient, safe and affordable. However, using these flasks might cause risks, disadvantages and inconveniences for patients: they are heavy and large; they restrict the mobility of patients (3,4) ; frequent clamping performed during transport might cause pulmonary collapse and formation of clots, (3,5) as well as hypertensive pneumothorax; the placement of the flask, always kept in a level below the thorax of the patient, facilitates the disconnection of one of the connections (3) ; and the bubbling inside the flask, when connected to continuous suction, causes an unpleasant sound. (6) We must emphasize the fact that using this method in a prehospital environment is inappropriate, because it is not only difficult to keep the flask below the patient, but it is also necessary to perform frequent clamping inside the limited space of an ambulance.…”

Section: Methodsmentioning

confidence: 99%

“…Chest X-ray results after the removal of the drainage system this initiative, there has been interest in developing a drainage method that would replace the water-seal system for the treatment of pleural diseases, (8,17) as well as in the postoperative management following thoracotomies. (4,6,7) However, the method most commonly used as an alternative to replace the water-seal system is still the Heimlich valve.…”

Section: Days (Median 4 Days)mentioning

confidence: 99%

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

Vega

Ortega²,

Tincani

et al. 2008

J. bras. pneumol.

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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.

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Effect of Heimlich valve and underwater seal on lung expansion after pulmonary resection

Bar

Papiashvilli

2009

Indian J Thorac Cardiovasc Surg

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IntroductionUnderwater seal (UWS) drainage systems maintain a one-way flow of fluid and air and are widely used in the management of patients after pulmonary resection. The drawbacks of UWS systems are the dead air space within the separate collection bottles and tubes and the limits of gravity. Flutter valves are one-way valves with a vented outlet that allow air and fluid to escape from, but not enter, the pleural cavity; and have been favorably used in the treatment of patients following Lung Volume Reduction (LVR) surgery 1 . A comparison Abstract Background: A study was undertaken to compare the physiologic and clinical effects of Under Water Seal (UWS) versus Heimlich Valve (HV) pleural drainage systems in the treatment of patients following pulmonary resection.Methods: Twenty patients post pulmonary resection (lobectomy -13, wedge resections -6, bullectomy -1) were studied. The relative intrapleural pressures were measured by a flow meter that was subsequently connected to a UWS and to an HV through straight and curved chest tubes. The quantity of the air leak, if present, was also gauged by a flow meter, and the degree of lung expansion was recorded by chest radiography.Results: At resting tidal volume the relative intrapleural pressures measured when using an HV were more negative than those measured when using a UWS. The differences between end-inspiratory and endexpiratory relative intrapleural pressures were greater with a UWS than with an HV. The forced endexpiratory pressures were higher with an HV than a UWS.Conclusions: The HV maintains more negative intrapleural pressure than a UWS, promotes more effective removal of excess air from the pleural space and ensures more complete expansion of the lung. The HV is superior to a UWS in physiologic postoperative conditions, and may also be preferable in the management of patients with an air leak and residual spaces. (Ind J Thorac Cardiovasc Surg 2009; 25: 183-187)

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A physiological comparison of flutter valve drainage bags and underwater seal systems for postoperative air leaks

Cited by 16 publications

References 5 publications

Comparison between Flutter Valve Drainage Bag and Underwater Seal Device for Pleural Drainage after Lung Surgery

Comparison between Flutter Valve Drainage Bag and Underwater Seal Device for Pleural Drainage after Lung Surgery

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

Effect of Heimlich valve and underwater seal on lung expansion after pulmonary resection

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