1036 A NEW DEVICE FOR DIAGNOSIS AND EVACUATION OF NEONATAL PNEUMOTHORACES

Abstract

A closed system (CS) device with teflon needle, sideholes, and attached stopcock was compared to a Medicut needle to determine incidence of unintentional introduction of air during diagnosis, and efficiency of evacuation of neonatal pneumothoraces (PTX). Thoracentesis was evaluated in 10 white rabbits (1.3-1.6 kg) with the CS needle in R chest and Medicut in L chest. Evacuation of free intrapleural air following thoracentesis and evacuation of intentionally injected air (20 cc) was performed on both sides of the chest. Intrapleural pressure measurements, x-rays,and number ml. air evacuated were used to quantitate each step. The CS needle produced no air entry on x-ray and no changes (P>0.05) in (mean ± SEM) inspiratory pleural pressure (IPP) (-5.2 ± 0.62 cm H2O) or expiratory pleural pressure (EPP) (-0.94 ± 0.55). Medicut taps (4.5 sec. to position stopcock) resulted in PTX on x-ray in 70% of trials and significant increase (P<0.05) of 1.28 ± 0.28 cm H2O in IPP and 1.58 ± 0.36 cm H2O EPP from baseline values. 23.7 cc (mean) air was evacuated from Medicut side. After 20 cc injection of air on CS needle side, a mean of 25.0 cc air was removed. Complete air evacuation occurred in 90% of CS needle trials vs. 60% with Medicut. The CS needle was safer, and more efficient than Medicut in evacuating air. In addition, since it is an airtight system, the CS needle can be used for diagnosis of PTX without the risk of introducing air.