French Sizing of Medical Devices is not Fit for Purpose

Kibriya, Nabil; Hall, Richard S.; Powell, Steven; How, T.V.; McWilliams, Richard G.

doi:10.1007/s00270-013-0557-7

Cited by 2 publications

(2 citation statements)

References 1 publication

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“…Many physicians prefer larger catheters, but this can increase patient discomfort, procedure time and the risk of complications, such as the need for more dilation of the access tract and an increased bleeding risk 10 . There is a paucity of scientific data on the relationship between drain size and drainage efficiency, and the suitability of the current drain sizing system has been questioned 11 , 12 . Among other factors influencing the technical success of percutaneous catheter drainage, the viscosity of the fluid and the amount and size of solid particles in the fluid should be considered when discussing the required catheter size.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of viscosities of typical drainage fluids to promote more evidence-based catheter size selection

Celik,

Goertz,

Henze

et al. 2023

Sci Rep

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Percutaneous drainage is a first-line therapy for abscesses and other fluid collections. However, experimental data on the viscosity of body fluids are scarce. This study analyses the apparent viscosity of serous, purulent and biliary fluids to provide reference data for the evaluation of drainage catheters. Serous, purulent and biliary fluid samples were collected during routine drainage procedures. In a first setup, the apparent kinematic viscosity of 50 fluid samples was measured using an Ubbelohde viscometer. In a second setup, the apparent dynamic viscosity of 20 fluid samples obtained during CT-guided percutaneous drainage was measured using an in-house designed capillary extrusion experiment. The median apparent kinematic viscosity was 0.96 mm2/s (IQR 0.90–1.15 mm2/s) for serous samples, 0.98 mm2/s (IQR 0.97–0.99 mm2/s) for purulent samples and 2.77 mm2/s (IQR 1.75–3.70 mm2/s) for biliary samples. The median apparent dynamic viscosity was 1.63 mPa*s (IQR 1.27–2.09 mPa*s) for serous samples, 2.45 mPa*s (IQR 1.69–3.22 mPa*s) for purulent samples and 3.50 mPa*s (IQR 2.81–3.90 mPa*s) for biliary samples (all differences p < 0.01). Relative to water, dynamic viscosities were increased by a factor of 1.36 for serous fluids, 2.26 for purulent fluids, and 4.03 for biliary fluids. Serous fluids have apparent viscosities similar to water, but biliary and purulent fluids are more viscous. These data can be used as a reference when selecting the drainage catheter size, with 8F catheters being appropriate for most percutaneous drainage cases.

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Section: Introductionmentioning

confidence: 99%

Evaluation of viscosities of typical drainage fluids to promote more evidence-based catheter size selection

Celik,

Goertz,

Henze

et al. 2023

Sci Rep

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show abstract

“…As a consequence, it has been called un t for purpose. [7] The vast majority of drains used by radiologists are self-retaining pigtail drains, whereas other specialties still prefer straight surgical drains under the assumption that these result in better drainage, notably for evacuation of pleural uid. Unfortunately, there has been little cross-disciplinary collaboration to bring together the expertise of the chest physician in pleural disease and the device expertise of the interventional radiologist.…”

Section: Introductionmentioning

confidence: 99%

Standardised comparison of chest and percutaneous drainage catheters: Size is not everything

Daga,

Milward,

Santos

et al. 2023

Preprint

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A variety of medical specialities undertake percutaneous drainage but understanding of device performance outside radiology is often limited. Furthermore, the current catheter sizing using the “French” measurement of outer diameter is unhelpful; it does not reflect the internal diameter and gives no information on flow rate. To illustrate this and to improve catheter selection, notably for chest drainage, we assessed the variation of drain performance under standardised conditions. Internal diameter and flow rates of 6Fr.-12Fr. drainage catheters from 7 manufacturers were tested to ISO 10555-1 standard: Internal diameters were measured with Meyer calibrated pin-gauges. Flow rates were calculated over a period of 30s after achieving steady state. Evaluation demonstrated a wide range of internal diameters for the 6Fr., 8Fr., 10Fr. and 12Fr. catheters. Mean measurements were 1.49mm (SD:0.07), 1.90mm (SD:0.10), 2.43mm (SD:0.11) and 2.64mm (SD:0.03) respectively. Mean flow rates were 128mL/min (SD:37.6), 207mL/min (SD: 55.1), 291mL/min (SD:36.7) and 303mL/min (SD:20.2) respectively. There was such variance that there was overlap between catheters of different size: thin-walled 10Fr. drains performed better than 12Fr. “Seldinger” chest drains. Better understanding of drain characteristics and better declaration of performance data by manufacturers are required to allow optimum drain choice for individual patients and optimum outcomes.

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French Sizing of Medical Devices is not Fit for Purpose

Cited by 2 publications

References 1 publication

Evaluation of viscosities of typical drainage fluids to promote more evidence-based catheter size selection

Evaluation of viscosities of typical drainage fluids to promote more evidence-based catheter size selection

Standardised comparison of chest and percutaneous drainage catheters: Size is not everything

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