12/16/2023 0 Comments Atrium pleur evac![]() Price, in The Interventional Cardiac Catheterization Handbook (Fourth Edition), 2018 Complications The blood simply goes from the chest tube into the blood collection bag, and a port on the bag is accessed to return the blood back to the patient. Other models offer continuous infusion directly from a blood collection bag and not the chest drainage device. The blood can then be continuously reinfused as it collects in the chest drainage system it goes from the blood collection chamber out the ATS access line and is pumped into the patient with an IV infusion pump in a closed system ( Fig. ![]() In this setup, a blood filter with intravenous (IV) blood tubing is hooked up to an IV infusion pump. Some models allow these chest drainage systems to be connected directly to the patient to provide continuous autotransfusion. Because blood first goes to the collection chamber of the chest drainage device, anticoagulant needs to be added to the collection chamber before blood enters it. The advantage of the ATS access line is that autotransfusion need not be anticipated before the chest tube collection system is connected to the chest tube. In devices without this option, any blood that goes into the chest drainage system is not available for transfusion. ![]() Not all devices permit withdrawal of blood directly from the chest drainage system. This is referred to as a self-filling ATS. Some devices have an additional port at the bottom called an ATS access line. Because blood goes directly into the blood collection bag, anticoagulant needs to be added to the blood collection bag before the blood flows into it.īlood may also be drawn directly from a chest drainage system. Eventually, when no more blood needs to be autotransfused, the blood collection bag is taken out of the series and the chest tube drainage system functions as usual. If the bag overfills, the fluid will spill into the usual chest fluid collection system. When the blood bag is filled, it is removed and replaced with a new blood collection bag. With this arrangement, blood goes from the patient to the blood collection bag to the chest drainage system. ![]() To collect blood for autotransfusion, a collection bag can be connected beforehand in series with the chest drainage system. These newer devices use a one-way valve instead of a water seal in stage 2 and a pressure regulator instead of water in the suction control stage (stage 3). Newer designs have solved this problem, and two systems currently available do not use water (Atrium Express and Pleur-evac Sahara ). The disadvantage of using water in stages 2 or 3 is that if the device is knocked over, loss of the water seal and spillage of water from the suction control stage can occur. Historically, water was (and still frequently is) used in the suction control stage. Stage 3 is the suction control stage, which is essentially a safety stage so that if the degree of suction suddenly increases beyond the set point, the system will pull air from the atmosphere instead of inappropriately increasing suction in the pleural cavity. Stage 2 is the water seal stage, in which water acts as a one-way valve (water seal) that allows air to be sucked out of the pleural space but not leak back in. Stage 1 is the collection of pleural fluid (blood). Currently used devices incorporate the three-bottle system into one unit. Roberts MD, FACEP, FAAEM, FACMT, in Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care, 2019 Autotransfusion UnitsĪll the commercially available autotransfusion systems (ATSs) are based on the same three-stage system (called the three-bottle system) for collection of pleural fluid ( Fig.
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