Editorial Type:
Analytic Techniques

In vitro evaluation of negative pressure generated during application of negative suction volumes by use of various syringes with and without thoracostomy tubes

Marguerite J. Mezzles 1Summit Veterinary Referral Center, 2505 S 80th St, Tacoma, WA 98409.

Search for other papers by Marguerite J. Mezzles in
Current site
Google Scholar
PubMed Close
 DVM
,
Rebecca L. Murray 1Summit Veterinary Referral Center, 2505 S 80th St, Tacoma, WA 98409.

Search for other papers by Rebecca L. Murray in
Current site
Google Scholar
PubMed Close
 DVM
, and
Brian P. Heiser 1Summit Veterinary Referral Center, 2505 S 80th St, Tacoma, WA 98409.

Search for other papers by Brian P. Heiser in
Current site
Google Scholar
PubMed Close
 DVM
DOI:
https://doi.org/10.2460/ajvr.80.7.625
Volume/Issue:
Volume 80: Issue 7
Online Publication Date:
01 Jul 2019
Restricted access
Sign In Reprints and Permissions Purchase Article

Abstract

OBJECTIVE

To determine the amount of negative pressure generated by syringes of various sizes with and without an attached thoracostomy tube and whether composition of thoracostomy tubes altered the negative pressure generated.

SAMPLE

Syringes ranging from 1 to 60 mL and 4 thoracostomy tubes of various compositions (1 red rubber catheter, 1 polyvinyl tube, and 2 silicone tubes).

PROCEDURES

A syringe or syringe with attached thoracostomy tube was connected to a pneumatic transducer. Each syringe was used to aspirate a volume of air 10 times. Negative pressure generated was measured and compared among the various syringe sizes and various thoracostomy tubes.

RESULTS

The negative pressure generated decreased as size of the syringe increased for a fixed volume across syringes. Addition of a thoracostomy tube further decreased the amount of negative pressure. The red rubber catheter resulted in the least amount of negative pressure, followed by the polyvinyl tube and then the silicone tubes. There was no significant difference in negative pressure between the 2 silicone tubes. The smallest amount of negative pressure generated was −74 to −83 mm Hg.

CONCLUSIONS AND CLINICAL RELEVANCE

Limited data are available on the negative pressure generated during intermittent evacuation of the thoracic cavity. For the present study, use of a syringe of ≥ 20 mL and application of 1 mL of negative suction volume resulted in in vitro pressures much more negative than the currently recommended pressure of −14.71 mm Hg for continuous suction. Additional in vitro or cadaveric studies are needed.

Abstract

OBJECTIVE

To determine the amount of negative pressure generated by syringes of various sizes with and without an attached thoracostomy tube and whether composition of thoracostomy tubes altered the negative pressure generated.

SAMPLE

Syringes ranging from 1 to 60 mL and 4 thoracostomy tubes of various compositions (1 red rubber catheter, 1 polyvinyl tube, and 2 silicone tubes).

PROCEDURES

A syringe or syringe with attached thoracostomy tube was connected to a pneumatic transducer. Each syringe was used to aspirate a volume of air 10 times. Negative pressure generated was measured and compared among the various syringe sizes and various thoracostomy tubes.

RESULTS

The negative pressure generated decreased as size of the syringe increased for a fixed volume across syringes. Addition of a thoracostomy tube further decreased the amount of negative pressure. The red rubber catheter resulted in the least amount of negative pressure, followed by the polyvinyl tube and then the silicone tubes. There was no significant difference in negative pressure between the 2 silicone tubes. The smallest amount of negative pressure generated was −74 to −83 mm Hg.

CONCLUSIONS AND CLINICAL RELEVANCE

Limited data are available on the negative pressure generated during intermittent evacuation of the thoracic cavity. For the present study, use of a syringe of ≥ 20 mL and application of 1 mL of negative suction volume resulted in in vitro pressures much more negative than the currently recommended pressure of −14.71 mm Hg for continuous suction. Additional in vitro or cadaveric studies are needed.

Contributor Notes

Address correspondence to Dr. Mezzles (mjrm84@gmail.com).
Cover American Journal of Veterinary Research
American Journal of Veterinary Research
Publication Date:
01 Jul 2019

  • 1. Blom JA. Anatomy and physiology of the lung and airways. In: Blom JA. Monitoring of respiration and circulation. Boca Raton, Fla: CRC Press Inc, 2004;3–23.

    • Search Google Scholar
    • Export Citation

  • 2. Randlinsky MG. Thoracic cavity. In: Tobias KM, Johnston SJ, eds. Veterinary surgery small animal. Vol 2. St Louis: Elsevier Saunders, 2012;1787–1812.

    • Search Google Scholar
    • Export Citation

  • 3. Rozanski EA, Mooney E. Pneumothorax. In: Bonagura JD, Twedt DC, eds. Kirk's current veterinary therapy. 15th ed. St Louis: Elsevier Saunders, 2014;700–704.

    • Search Google Scholar
    • Export Citation

  • 4. West JB. Mechanics of breathing. In: West JB. Respiratory physiology: the essentials. 9th ed. Baltimore: Lippincott Williams & Wilkins, 2012;95–124.

    • Search Google Scholar
    • Export Citation

  • 5. Boysen SR. Chest tubes part 1: types and indications. Companion Anim 2015;20:488–492.

  • 6. Day SL. Thoracostomy tube placement, drainage and management in dogs and cats. Vet Nurs J 2014;29:42–46.

  • 7. Sigrist NE. Thoracostomy tube placement and drainage. In: Silverstein D, Hopper K, eds. Small animal critical care medicine. 2nd ed. St Louis: Elsevier Saunders, 2014;1032–1035.

    • Search Google Scholar
    • Export Citation

  • 8. Tillson DM. Thoracostomy tubes. Part II: placement and maintenance. Compend Contin Educ Pract Vet 1997; 19:1331–1337.

  • 9. Tang A, Hooper T, Hasan R. A regional survey of chest drains: evidence-based practice? Postgrad Med J 1999;75:471–474.

  • 10. Zielinska-Krawczyk M, Krenke R, Grabczak EM, et al. Pleural manometry—historical background, rationale for use and methods of measurement. Respir Med 2018;136:21–28.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 11. Grabczak EM, Krenke R, Zielinska-Krawczyk M, et al. Pleural manometry in patients with pleural diseases—the usefulness in clinical practice. Respir Med 2018;145:230–236.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 12. Pannu J, DePew ZS, Mullon JJ, et al. Impact of pleural manometry on the development of chest discomfort during thoracentesis: a symptom-based study. J Bronchology Interv Pulmonol 2014;21:306–313.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 13. Feller-Kopman D, Walkey A, Berkowitz D, et al. The relationship of pleural pressure to symptom development during therapeutic thoracentesis. Chest 2006;129:1556–1560.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 14. Mahfood S, Hix WR, Aaron BL, et al. Reexpansion pulmonary edema. Ann Thorac Surg 1988;45:340–345.

  • 15. Ziskind MM, Weill H, George RA. Acute pulmonary edema following the treatment of spontaneous pneumothorax with excessive negative intrapleural pressure. Am Rev Respir Dis 1965;92:632–636.

    • Search Google Scholar
    • Export Citation

  • 16. Feller-Kopman D, Berkowitz D, Boiselle P, et al. Large-volume thoracentesis and the risk of reexpansion pulmonary edema. Ann Thorac Surg 2007;84:1656–1661.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 17. Dias OM, Teixeira LR, Vargas FS. Reexpansion pulmonary edema after therapeutic thoracentesis. Clinics 2010;65:1387–1389.

  • 18. Echevarria C, Twomey D, Dunning J, et al. Does re-expansion pulmonary oedema exist? Interact Cardiovasc Thorac Surg 2008;7:485–489.

  • 19. Kasmani R, Irani F, Okoli K, et al. Re-expansion pulmonary edema following thoracentesis. CMAJ 2010;182:2000–2002.

  • 20. Matsuura Y, Nomimura T, Murakami H, et al. Clinical analysis of reexpansion pulmonary edema. Chest 1991;100:1562–1566.

  • 21. Knox T, Davie J. Nasogastric tube feeding—which size syringe produces lower pressure and is safest to use? Nurs Times 2009;105:24–26.

    • Search Google Scholar
    • Export Citation

  • 22. Grinnell SK. Flow of a compressible fluid in a thin passage. Trans ASME 1956;78:765–771.

  • 23. Blom JA. Physics of fluid transport in tubes. In: Monitoring of respiration and circulation. Boca Raton, Fla: CRC Press Inc, 2004;45–70.

    • Search Google Scholar
    • Export Citation

  • 24. Fox RW, McDonald AT, Pritchard PJ. Motion of a fluid particle (kinematics). In: Fox RW, McDonald AT, Pritchard PJ. Introduction to fluid mechanics. 6th ed. Danvers, Mass: John Wiley & Sons Inc, 2004;197–211.

    • Search Google Scholar
    • Export Citation

Advertisement