Poiseuille Flow Through Chest Tubes: A Scoping Review
DOI:
https://doi.org/10.22024/UniKent/03/ajpp.1293Abstract
Background: Chest tubes are used daily to treat patients with chest pathologies such as haemothorax. However, there is much uncertainty around the fluid dynamics of chest tubes. Traditionally, authors have described fluid dynamics in chest tubes using Poiseuille’s law. However, in recent years authors have been challenging the applicability of Poiseuille’s law to chest tubes. It has been the norm for large-bore chest tubes to be used for larger fluid volumes such as haemothoraces because in theory, the larger the tube, the more efficient the drainage. Recently, however, there has been a shift to using smaller-bore catheters which are better tolerated by patients. It remains unclear what catheter size is best suited for drainage of fluids in differing chest pathologies. This scoping review was conducted to determine the current understanding of the hydrodynamics of fluid flow through chest tubes as well as addressing the long-standing debate on chest tube size.
Methods: The scoping review used the PRISMA Extension for Scoping Review (PRISMA-ScR) checklist. Core key words were identified and Boolean Operator and Medical Subject Headings (MeSh) were used to search a range of databases to yield both peer-reviewed journal articles and grey literature. The literature identified went through a two-stage review process by the author and project supervisor, using Rayyan. To extract data, a thematic analysis was carried out on the final chosen papers.
Results: A total of 922 papers were identified from the search. After title and abstract review and further critical appraisal, a total of 15 final papers were included in the final scoping review. Primarily, these consisted of narrative studies summarising current practices, as well as several in-vitro laboratory experiments studying fluid dynamics through chest tubes. There was a general lack of literature on this topic overall. There was an increase in papers published between 2005-2010 but generally, over a 30-year period there has not been a big focus on this topic.
Conclusions: The scoping review has re-examined fluid flow through chest tubes that has been defined in the literature, particularly around Poiseuille’s law and flow. Many have concluded that the location and position of chest tubes and the clinical environment do not allow for Poiseuille flow to fully develop. Poiseuille’s law was also found to not be predictive of actual flow rates in different size chest tubes. Authors found discrepancies between predicted and measured flow rates. These discrepancies were attributed to the interruption in flow due to holes, kinks, positioning and other features of chest tubes, like three-way taps, which create resistance within the circuit. This review also looked at comparing small-bore chest tubes to large-bore chest tubes where common practice has been to insert large chest tubes for haemothorax or empyema based on principles of Poiseuille’s law. This review found that many authors are now in favour of using smaller-bore catheters due to lack of evidence that larger bore tubes offer any clinical advantage over smaller bore tubes.
##submission.downloads##
Publicerad
Referera så här
Nummer
Sektion
Licens
© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
AJPP requests that, as the creator(s)/author(s) of the manuscript you are submitting, that you assign certain rights to the manuscript to the AJPP in exchange for undertaking to publish the article in electronic form and, in general, to pursue its dissemination throughout the world. The rights the AJPP requests are:
- The right to publish the article in electronic form or in any other form it may choose that is in keeping with its role as a scholarly journal with the goal of disseminating the work as widely as possible;
- The right to be the sole publisher of the article for a period of 12 months;
- The right to make the article available to the public within a period of not more than 24 months, as determined by relevant journal staff of the AJPP;
- The right to grant republication rights to itself or others in print, electronic, or any other form, with any revenues accrued to be shared equally between the author(s) and the journal;
- The right to administer permission to use portions of the article as requested by others, seeking recompense when the AJPP sees it as warranted;
- The right to seek or take advantage of opportunities to have the article included in a database aimed at increasing awareness of it;
- As the author(s), the AJPP wishes you to retain the right to republish the article, with acknowledgement of the AJPP as the original publisher, in whole or in part, in any other pbulication of your own, including any anthology that you might edit with up to three others;
- As the author(s), the AJPP wishes you to retain the right to place the article on your personal Web page or respository of your university or institution. The AJPP askes that you include this notice: A fully edited, peer-reviewed version of this article was first published by the Advanced Journal of Professional Practice, <Year>, <Volume>, <Issue>, <Page Numbers>.
- You retain the right to unrestricted use of your paper for yourself or for your own teaching purposes.
BY AGREEING TO THE FOREGOING, YOU CONFIRM THAT THE MANUSCRIPT YOU ARE SUBMITTING HAS NOT BEEN PUBLISHED ELSEWHERE IN WHOLE OR IN PART, AND THAT NO AGREEMENT TO PUBLISH IS OUTSTANDING.
SHOULD THE ARTICLE CONTAIN MATERIAL WHICH REQUIRES WRITTEN PERMISSION FOR INCLUSION, YOU AGREE THAT IT IS YOUR OBLIGATION IN LAW TO IDENTIFY SUCH MATERIAL TO THE EDITOR OF THE AJPP AND TO OBTAIN SUCH PERMISSION. THE AJPP WILL NOT PAY ANY PERMISSION FEES. SHOULD THE AJPP BE OF THE OPINION THAT SUCH PERMISSION IS NECESSARY, IT WILL REQUIRE YOU TO PURSUE SUCH PERMISSSION PRIOR TO PUBLICATION.
AS AUTHOR(S), YOU WARRANT THAT THE ARTICLE BEING SUBMITTED IS ORIGINAL TO YOU.
Provided the foregoing terms are satisfactory, and that you are in agreement with them, please indicate your acceptance by checking the appropriate box and proceed with your submission.
