Re-discovering the heimlich valve: Old wine in a new bottle

Abstract

A 14-year-old boy came to our outpatient department with pleuritic chest pain and dyspnea. He was found to have a loculated empyema on the right side. He was taken up for surgery and decortication was done. He developed air leak in the postoperative period. When the air leak did not settle until the 10th day, we decided to attach the atrium Pneumostat™, a modified version of the Heimlich valve to his Intercostal drainage tube and sent him home. On further follow-up, his lung expanded, and ICD could be removed. The patient remains well until the current follow-up. We present this case in an attempt to change the perceptions about various options available to drain the chest. The Heimlich valve appears to be a more compliant option than the conventional underwater seal drainage in terms of early mobility, reduced length of stay, and patient compliance.

Heimlich Valve as an Ambulation Management of Persistent Pneumothorax or Fluidopneumothorax

“…This condition can cause shortness of breath, which in certain conditions can cause life-threatening tension. 1 The procedure for expelling air, fluids, or blood is performed by placing a chest tube. During hospitalization, the chest tube will be connected to WSD.…”

“…The clinician needs to evaluate for valve occlusion, valve leakage, discoloration of chest fluid secretions, and clinical signs of complications in the patient such as pneumothorax, infection, or subcutis emphysema. 1 Radiological investigations will be performed periodically to evaluate the patient's lung condition, whether it is an improvement or a worsening of the condition. Patients can come to the doctor outside their routine schedule if they experience high fever, intense feeling of tightness, chest pain, swelling of the neck or hands, pain that increases and does not go away by pain medication, the skin around the chest tube is red, swollen, or feels warm, painful to the touch, the amount of liquid from the collection bag increases, the liquid changes color or cloudy, and smells.…”

“…The pneumostat chest drain valve is an innovation that adopts the one-way Heimlich valve which immediately has a small drainage space. 1 The non-return valve is able to remove air leaks and prevent air from re-entering the thoracic cavity. The small drainage space can accommodate about 30 ml of liquid which can be removed through the end of the distal chamber (sample port) by suction using a syringe.…”

“…In 1873, Playfair first introduced the concept of Water Seal Drainage (WSD) to treat thoracic empyema in a child. 1 The concept of WSD is still used in various hospitals to treat cases of pleural effusion, pneumothorax, or fluidopneumothorax. The shape and design of the WSD device are developing and become modern.…”