Department of Thoracic Surgery, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany.
ATMOS Medizintechnik GmbH & Co. KG, Lenzkirch, Germany.
Surg Innov. 2024 Apr;31(2):185-194. doi: 10.1177/15533506241232618. Epub 2024 Feb 25.
To date, several chest drainage systems are available, such as digital drainage systems (DDS) and traditional systems with continuous suction or water seal. However, none of these systems were yet shown to be favorable in the treatment of complex situations such as persistent air leaks or residual spaces. We present in-vitro as well as clinical data of a novel hybrid drainage system consisting of an optimized digital drainage system (ODDS) and an underwater seal drainage system (UWSD).
For in-vitro analysis, a DDS and an ODDS were connected to a pleural cavity simulator. Different air leaks were produced and data on intrapleural pressure and air flow were analyzed. Furthermore, we tested the hybrid drainage system in 10 patients with potential air leaks after pulmonary surgery.
In in-vitro analysis, we could show, that with advanced pump technology, pressure fluctuations caused by the drainage system when trying to maintain a set pressure level in patients with airleaks were much smaller when using an ODDS and could even be eliminated when using a fluid collection canister with sufficient buffer capacity. This minimized air leak boosts caused by the drainage system. Optimizing the auto-pressure regulation algorithms also led to a reduced airflow through the fistula and promoted rest. Switching to a passive UWSD also reduced the amount of airflow. Clinical application of the hybrid drainage system yielded promising results.
The novel hybrid drainage system shows promising results in the treatment of patients with complex clinical situations such as persistent air leaks.
迄今为止，已经有几种胸腔引流系统可供选择，例如数字引流系统（DDS）和带持续抽吸或水封的传统系统。然而，在处理持续漏气或残留空间等复杂情况时，这些系统都没有表现出明显的优势。我们提出了一种新型混合引流系统的体外和临床数据，该系统由优化的数字引流系统（ODDS）和水下密封引流系统（UWSD）组成。
为了进行体外分析，将 DDS 和 ODDS 连接到胸腔模拟器上。产生不同的漏气，并分析胸腔内压力和气流的数据。此外，我们在 10 例有潜在漏气风险的肺手术后患者中测试了混合引流系统。
在体外分析中，我们可以证明，通过先进的泵技术，当试图在漏气患者中维持设定的压力水平时，引流系统引起的压力波动使用 ODDS 时要小得多，甚至可以通过使用具有足够缓冲能力的集液罐来消除。这最大限度地减少了引流系统引起的漏气增加。优化自动压力调节算法也导致通过瘘口的气流减少，促进了休息。切换到被动 UWSD 也减少了气流量。混合引流系统的临床应用取得了有希望的结果。
新型混合引流系统在治疗持续漏气等复杂临床情况的患者方面显示出有希望的结果。
