AIRFIX®: the first digital postoperative chest tube airflowmetry—a novel method to quantify air leakage after lung resection

• Published in: European journal of cardio-thoracic surgery 2006-06, Vol.29 (6), p.867-872
• Main Authors: Anegg, Udo, Lindenmann, Jorg, Matzi, Veronika, Mujkic, Dzenana, Maier, Alfred, Fritz, Lukas, Smolle-Jüttner, Freyja Maria
• Format: Article
• Language: English
• Subjects: Airflowmetry; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - surgery; Cardiology. Vascular system; Chest Tubes; Diagnosis, Computer-Assisted - instrumentation; Diagnosis, Computer-Assisted - methods; Equipment Design; Humans; Lung Neoplasms - surgery; Medical sciences; Pneumology; Pneumonectomy - adverse effects; Pneumothorax; Pneumothorax - diagnosis; Pneumothorax - etiology; Point-of-Care Systems; Postoperative Care - instrumentation; Postoperative Care - methods; Pulmonary air-leaks; Respiratory Mechanics; Respiratory system : syndromes and miscellaneous diseases; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/j.ejcts.2006.03.026

Objective: Prolonged air leak after pulmonary resection is a common complication and a major limiting factor for early discharge from hospital. Currently there is little consensus on its management. The aim of this study was to develop and evaluate a measuring device which allows a simple digital bed-side quantification of air-leaks compatible to standard thoracic drainage systems. Patients and methods: The measuring device (AIRFIX®) is based upon a ‘mass airflow’ sensor with a specially designed software package that is connected to a thoracic suction drainage system. Its efficacy in detecting pulmonary air-leaks was evaluated in a series of 204 patients; all postoperative measurements were done under standardized conditions; the patients were asked to cough, to take a deep breath, to breathe out against the resistance of a flutter valve, to keep breath and to breathe normally. As standard parameters, the leakage per breath or cough (ml/b) as well as the leakage per minute (ml/min) were displayed and recorded on the computer. Results: Air-leaks within a range of 0.25–45 ml/b and 5–900 ml/min were found. Removal of the chest tubes was done when leakage volume on Heimlich valve was less than 1.0 ml/b or 20 ml/min. After drain removal based upon the data from chest tube airflowmetry none of the patients needed re-drainage due to pneumothorax. Conclusion: The AIRFIX® device for bed-side quantification of air-leaks has proved to be very simple and helpful in diagnosis and management of air-leaks after lung surgery, permitting drain removal without tentative clamping.