title: Novel Split Chest Tube Improves Post-Surgical Thoracic Drainage.
abstract: OBJECTIVE
  Conventional, separate mediastinal and pleural tubes are often inefficient at draining thoracic effusions.
  
  
  METHODS
  We developed a Y-shaped chest tube with split ends that divide within the thoracic cavity, permitting separate intrathoracic placement and requiring a single exit port. In this study, thoracic drainage by the split drain vs. that of separate drains was tested.
  
  
  METHODS
  After sternotomy, pericardiotomy, and left pleurotomy, pigs were fitted with separate chest drains (n=10) or a split tube prototype (n=9) with internal openings positioned in the mediastinum and in the costo-diaphragmatic recess. Separate series of experiments were conducted to test drainage of D5W or 0.58 M sucrose, an aqueous solution with viscosity approximating that of plasma. One litre of fluid was infused into the thorax, and suction was applied at -20 cm H2O for 30 min.
  
  
  RESULTS
  When D5W was infused, the split drain left a residual volume of 53 ± 99 ml (mean value ± SD) vs. 148 ± 120 for the separate drain (P=0.007), representing a drainage efficiency (i.e. drained vol/[drained + residual vol]) of 95 ± 10% vs. 86 ± 12% for the separate drains (P = 0.011). In the second series, the split drain evacuated more 0.58 M sucrose in the first minute (967 ± 129 ml) than the separate drains (680 ± 192 ml, P<0.001). By 30 min, the split drain evacuated a similar volume of sucrose vs. the conventional drain (1089 ± 72 vs. 1056 ± 78 ml; P = 0.5). Residual volume tended to be lower (25 ± 10 vs. 62 ± 72 ml; P = 0.128) and drainage efficiency tended to be higher (98 ± 1 vs. 95 ± 6%; P = 0.111) with the split drain vs. conventional separate drains.
  
  
  CONCLUSIONS
  The split chest tube drained the thoracic cavity at least as effectively as conventional separate tubes. This new device could potentially alleviate postoperative complications.
authors.affiliation: Departments of Surgery, University of North Texas Health Science Center, Fort Worth, TX, USA ; Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: Albert H
authors.initials: AH
authors.lastname: Olivencia-Yurvati
authors.affiliation: Departments of Integrative Physiology, University of North Texas Health Science Center, Fort Worth, TX, USA ; Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: Brandon H
authors.initials: BH
authors.lastname: Cherry
authors.affiliation: Departments of Integrative Physiology, University of North Texas Health Science Center, Fort Worth, TX, USA ; Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: Hunaid A
authors.initials: HA
authors.lastname: Gurji
authors.affiliation: Departments of Integrative Physiology, University of North Texas Health Science Center, Fort Worth, TX, USA ; Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: White
authors.affiliation: Departments of Surgery, University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: J Tyler
authors.initials: JT
authors.lastname: Newton
authors.affiliation: Departments of Integrative Physiology, University of North Texas Health Science Center, Fort Worth, TX, USA ; Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: Gary F
authors.initials: GF
authors.lastname: Scott
authors.affiliation: Departments of Surgery, University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: Besim
authors.initials: B
authors.lastname: Hoxha
authors.affiliation: Bioengineering Unit, Wolfson Centre, University of Strathclyde, Glasgow, UK.
authors.forename: Terence
authors.initials: T
authors.lastname: Gourlay
authors.affiliation: Departments of Surgery, University of North Texas Health Science Center, Fort Worth, TX, USA ; Departments of Integrative Physiology, University of North Texas Health Science Center, Fort Worth, TX, USA ; Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Mallet
keywords: Chest; Pleural effusion; Pleural space; Surgical equipment; Thoracotomy