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Chen CH, Liu TP, Chang H, Huang TS, Liu HC, Chen CH. A chest drainage system with a real-time pressure monitoring device. J Thorac Dis 2015; 7:1119-24. [PMID: 26380726 DOI: 10.3978/j.issn.2072-1439.2015.07.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 06/01/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND Tube thoracostomy is a common procedure. A chest bottle may be used to both collect fluids and monitor the recovery of the chest condition. The presence of the "tidaling phenomenon" in the bottle can be reflective of the extent of patient's recovery. OBJECTIVES However, current practice essentially depends on gross observation of the bottle. The device used here is designed for a real-time monitoring of change in pleural pressure to allow clinicians to objectively determine when the lung has recovered, which is crucially important in order to judge when to remove the chest tube. METHODS The device is made of a pressure sensor with an operating range between -100 to +100 cmH2O and an amplifying using the "Wheatstone bridge" concept. Recording and analysis was performed with LABview software. The data can be shown in real-time on screen and also be checked retrospectively. The device was connected to the second part of a three-bottle drain system by a three-way connector. RESULTS The test animals were two 40-kg pigs. We used a thoracoscopic procedure to create an artificial lung laceration with endoscopic scissors. Active air leaks could result in vigorous tidaling phenomenon up to 20 cmH2O. In the absence of gross tidaling phenomenon, the pressure changes were around 0.25 cmH2O. CONCLUSIONS This real-time pleural pressure monitoring device can help clinicians objectively judge the extent of recovery of the chest condition. It can be used as an effective adjunct with the current chest drain system.
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Affiliation(s)
- Chih-Hao Chen
- 1 Department of Medicine, Mackay Medical College, New Taipei City, Taiwan ; 2 Department of Thoracic Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 3 Mackay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan ; 4 Department of General Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 5 Graduate Institute of Manufacturing Technology, National Taipei University of Technology, Taipei 10608, Taiwan
| | - Tsang-Pai Liu
- 1 Department of Medicine, Mackay Medical College, New Taipei City, Taiwan ; 2 Department of Thoracic Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 3 Mackay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan ; 4 Department of General Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 5 Graduate Institute of Manufacturing Technology, National Taipei University of Technology, Taipei 10608, Taiwan
| | - Ho Chang
- 1 Department of Medicine, Mackay Medical College, New Taipei City, Taiwan ; 2 Department of Thoracic Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 3 Mackay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan ; 4 Department of General Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 5 Graduate Institute of Manufacturing Technology, National Taipei University of Technology, Taipei 10608, Taiwan
| | - Tung-Sung Huang
- 1 Department of Medicine, Mackay Medical College, New Taipei City, Taiwan ; 2 Department of Thoracic Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 3 Mackay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan ; 4 Department of General Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 5 Graduate Institute of Manufacturing Technology, National Taipei University of Technology, Taipei 10608, Taiwan
| | - Hung-Chang Liu
- 1 Department of Medicine, Mackay Medical College, New Taipei City, Taiwan ; 2 Department of Thoracic Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 3 Mackay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan ; 4 Department of General Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 5 Graduate Institute of Manufacturing Technology, National Taipei University of Technology, Taipei 10608, Taiwan
| | - Chao-Hung Chen
- 1 Department of Medicine, Mackay Medical College, New Taipei City, Taiwan ; 2 Department of Thoracic Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 3 Mackay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan ; 4 Department of General Surgery, Mackay Memorial Hospital, Taipei City, Taiwan ; 5 Graduate Institute of Manufacturing Technology, National Taipei University of Technology, Taipei 10608, Taiwan
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Abstract
Assessment of the jugular venous pressure is often inadequately performed and undervalued. Here, we review the physiologic and anatomic basis for the jugular venous pressure, including the discrepancy between right atrial and central venous pressures. We also describe the correct method of evaluating this clinical finding and review the clinical relevance of the jugular venous pressure, especially its value in assessing the severity and response to treatment of congestive heart failure. Waveforms reflective of specific conditions are also discussed.
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