A novel pleural-bladder pump for the management of recurrent malignant pleural effusions: a feasibility animal study.
Malignant pleural effusion
Pleural drainage
Pleural pump
Thoracoscopy
Journal
Respiratory research
ISSN: 1465-993X
Titre abrégé: Respir Res
Pays: England
ID NLM: 101090633
Informations de publication
Date de publication:
15 Jul 2020
15 Jul 2020
Historique:
received:
22
02
2020
accepted:
08
07
2020
entrez:
17
7
2020
pubmed:
17
7
2020
medline:
10
6
2021
Statut:
epublish
Résumé
Recurrent malignant pleural effusions (MPE) are common and associated with significant morbidity in cancer patients. A new pump connecting the pleural cavity and the bladder may have application for the management of recurrent MPE. In a pre-clinical study, we investigated the utility of this pump in healthy pigs. A novel pump system (Pleurapump® system) was inserted into four pigs under general anaesthesia. A tunnelled-pleural catheter was connected to a subcutaneously implanted pump while the urinary bladder was connected by percutaneous technique. Animals were ventilated mechanically and pump functioning was tested using a range of ventilation parameters and spontaneous breathing. Fluid was added to the pleural space to mimic pleural effusion and to assess the effectiveness of the pump at removing fluid to the bladder. The 'pleurapump' system successfully transported fluid from the pleural cavity to the bladder. Pressure variations caused by respiration and variations in the amount of fluid in the pleural cavity had no impact on the pumping. Pumping stopped when the pleural cavity was drained. This pump can be implanted into pigs and successfully removed fluid from the pleural cavity to the bladder and may represent a new treatment for management of recurrent MPE. Evaluation in humans is planned.
Sections du résumé
BACKGROUND
BACKGROUND
Recurrent malignant pleural effusions (MPE) are common and associated with significant morbidity in cancer patients. A new pump connecting the pleural cavity and the bladder may have application for the management of recurrent MPE. In a pre-clinical study, we investigated the utility of this pump in healthy pigs.
METHODS
METHODS
A novel pump system (Pleurapump® system) was inserted into four pigs under general anaesthesia. A tunnelled-pleural catheter was connected to a subcutaneously implanted pump while the urinary bladder was connected by percutaneous technique. Animals were ventilated mechanically and pump functioning was tested using a range of ventilation parameters and spontaneous breathing. Fluid was added to the pleural space to mimic pleural effusion and to assess the effectiveness of the pump at removing fluid to the bladder.
RESULTS
RESULTS
The 'pleurapump' system successfully transported fluid from the pleural cavity to the bladder. Pressure variations caused by respiration and variations in the amount of fluid in the pleural cavity had no impact on the pumping. Pumping stopped when the pleural cavity was drained.
CONCLUSION
CONCLUSIONS
This pump can be implanted into pigs and successfully removed fluid from the pleural cavity to the bladder and may represent a new treatment for management of recurrent MPE. Evaluation in humans is planned.
Identifiants
pubmed: 32669106
doi: 10.1186/s12931-020-01447-4
pii: 10.1186/s12931-020-01447-4
pmc: PMC7364624
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
184Références
JAMA. 2012 Jun 13;307(22):2383-9
pubmed: 22610520
Eur Respir J. 2018 Jul 27;52(1):
pubmed: 30054348
Clin Chest Med. 2013 Sep;34(3):459-71
pubmed: 23993817
J Hepatol. 2013 May;58(5):922-7
pubmed: 23318604
Curr Opin Pulm Med. 2013 Jul;19(4):374-9
pubmed: 23673450
Semin Respir Crit Care Med. 2014 Dec;35(6):732-43
pubmed: 25463164
Thorax. 2010 Aug;65 Suppl 2:ii32-40
pubmed: 20696691
Chest. 2014 Oct;146(4):991-1000
pubmed: 24832000
Am J Respir Crit Care Med. 2012 Sep 15;186(6):487-92
pubmed: 22652027
Respiration. 2013;85(1):36-42
pubmed: 23154202