New Chest Drainage Unit with Integrated CO2-Detector Demonstrates False Air Leak

Background Postoperative observed air leakage does not always originate from parenchymal defects but may arise from defects in the chest drainage unit, connections or reverse airflow in water seals. We investigated such false air leakage using a new chest drainage unit with a built-in CO2-detector and an electronic chest drainage unit. Methods Two types of chest drainage units were tested in a simple porcine model: A well-known electronic chest drainage unit and a new chest drainage unit with integrated CO2-detector. We created a setup of true air leakage—a parenchymal lesion, and false air leakage—allowing air to flow into the thoracic cavity alongside the chest drain. Results We demonstrated that the new chest drainage unit with a built-in CO2-detector can distinguish between experimentally induced true air leakage and false air leakage. Conclusion Available chest drainage systems do not allow direct assessment of true or false air leakage, which may increase chest drain duration unnecessarily. The integration of a CO2-sensitive color indicator into a chest drainage unit allows simple distinction between false air leak and true air leak, which may improve postoperative management.

Abstract 154: Correlation Between Site of Venous Occlusion and Clinical Syndromes in Cerebral Venous Thrombosis

Introduction: Cerebral venous thrombosis (CVT) is an uncommon cerebrovascular condition, which presents with a wide spectrum of symptoms' onset and clinical syndromes. Hypothesis: We assessed the hypothesis that there is a correlation among the main clinical syndromes in CVT and the sites of venous occlusion; also we analyzed functional outcome on each clinical syndrome in the acute setting (30-days). Methods: This is a retrospective analysis from a systematic database of hospitalized patients from January 1979 to December 2014. Univariate and adjusted multivariate models were used to evaluate in a first step, association between clinical syndromes and affected vessels, and in a second step functional outcome in the acute setting (30-day follow-up). Clinical syndromes were classified as: focal syndrome, encephalopathy, isolated intracranial hypertension, meningeal syndrome. Affected vessels were classified as isolated thrombosis or vessels combinations. Functional outcome was based on modified Rankin score (mRs) at 30- and 90-day (good functional outcome, mRs = 0-2). Results: 467 confirmed CVT patients (81.6% women, median age: 29 years, IQR: 22-38 years). Isolated superior sagittal sinus (82.0%), lateral sinus (50.1%), and the combination of them (22.1%) were the most prevalent affected vessels. Good functional outcome was present in 359 (76.9%) and 394 (84.4%) of all patients, at 30- and 90-day respectively. Focal syndrome was associated with hemorrhagic (OR 11.8, 95% CI 5.59-25.0); encephalopathy with the combination of Vein of Galen + Straight sinus (OR 6.52, 95% CI 2.13-19.9); isolated intracranial hypertension was associated with the absence of parenchymal lesion (OR 71.8, 95% CI 25.1-205); meningeal syndrome was associated with the combination of deep and superficial venous thrombosis (OR 3.22, 95% CI 1.61-6.43). Good functional outcome at 30- and 90-day was mainly associated to absence of encephalopathy (HR 0.74) and absence of meningeal syndrome (HR 0.85). Conclusions: Focal syndrome depends on the type of parenchymal lesion; encephalopathy depends on the compromise of deep venous system; the strongest associations for 30-day mortality were found on the presence of meningeal and focal syndromes.