Heimlich Valve as an Ambulation Management of Persistent Pneumothorax or Fluidopneumothorax

Abstract

Pneumothorax or fluidopneumothorax is a critical condition when there is some air or/and fluid in the plural cavity. The symptoms may include shortness of breath, chest pain, blue discoloration of the skin or lips, increased heart rate, and loss of consciousness. Pleural cavity drainage is management therapy with the concept of Water Seal Drainage (WSD), which requires a long hospital stay. Heimlich valve is a non-return valve that allows fluid and air to exit the thoracic cavity (on inspiration) and prevents fluid and air from re-entering (during expiration). Heimlich valve is a viable, inexpensive, convenient, safe, effective, and efficient alternative in the management of ambulation of patients requiring prolonged pleural cavity drainage. The use of Heimlich valve is an alternative option for patients with persistent pneumothorax or fluidopneumothorax. It can shorten the time of treatment in the hospital, lowering treatment costs, and minimize the presence of nosocomial infections. Relative contraindications include fluidopneumothorax with massive pleural effusion or empyema. The risks and complications are dislodgement or improper reattachment, leaking valve, adhesion, and blockage, thus becoming tension pneumothorax or pleural cavity infection. Currently the latest innovation also improves the patient’s convenience, like Thoracic Vent, Pneumostat, or Mini Mobile Dry Seal Drain.

Pulmonary and intestinal tuberculosis with COVID-19 complicated with fluidopneumothorax and colovesical fistula: The importance of diagnosis complexity in line with clinical setting

“…This was the complication of pulmonary TB. Hydropneumothorax is a critical condition when there is an abnormal presence of air and fluid in the pleural space [ 8 , 9 ]. This patient had symptoms of dyspnea, asymmetrical chest movement, lagging left, palpable fremitus decreased 2/3 of the lower parenchyma, hyper resonance on percussion of the lower 2/3 of the left hemithorax, and auscultation of breath sounds were lost in the lower 2/3 of the left hemithorax which leads to the presence of pneumothorax.…”

“…A chest tube (or intercostal drain) is the most definitive initial treatment of a hydropneumothorax. WSD is used in various hospitals to treat cases of pleural effusion, pneumothorax, or hydropneumothorax [9] . An intercostal drain (ICD) device is inserted for drainage.…”

“…COVID-19), and complications [7] . Hydropneumothorax is a critical condition when there is an abnormal presence of air and fluid in the pleural space [ 8 , 9 ]. Hydropneumothorax is a complication of pulmonary TB and causes significant morbidity [ 8 , 10 ].…”

One-Way Valve as Management of Chest Tube Ambulation in Pneumothorax Cases

“…Make sure the plaster is installed properly to prevent its shift or accidental disconnection of the hose. 6 Monitoring Heimlich valve use should also assess for injury at the insertion site chest tube. Every part and side is connected to the drainage system and drainage bag.…”