Safer care for enhanced recovery

Thopaz+ Digital Chest Drainage and Monitoring System*
*Monitoring of fluid drainage, air leak and pressure

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Medela provides a comprehensive chest drainage solution for cardiac patients

Treating patients for cardiac disorders is no easy task. It requires careful monitoring and great sensitivity towards patient recovery. While there are many factors that can impact a patient’s recovery after cardiac surgery, experts agree that a functioning drainage system is one of the most vital tools for preventing complications after cardiac surgery and reducing the length of hospital stay.

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Incidence of bleeding in post-operative cardiac surgery
  • Excessive bleeding post-cardiac surgery can trigger sepsis, acute respiratory distress syndrome and/or renal failure, and can be fatal.1
  • Nurses and heart surgeons must evaluate and register chest tube drainage, thromboelastogram monitoring, platelet mapping and modifiable predictive factors of increased bleeding, such as metabolic acidosis and post-operative heart rate.2

1 Pereira KMFSM, de Assis CS, Cintra HNWL, et al. Factors Associated With the Increased Bleeding in the Postoperative Period of Cardiac Surgery: A Cohort Study. J Clin Nurs 2019;28(5–6):850–61.

2 Christensen MC, Krapf S, Kempel A, et al. Costs of Excessive Postoperative Hemorrhage in Cardiac Surgery. J Thorac Cardiovasc Surg 2009;138(3):687–93.

  • Thopaz+ provides accurate digital drainage measurement and trends during the critical post-op window.3
  • The Thopaz+ objective data helps the communication between staff and physicians and facilitates easy decision making.4
  • Although air leaks are seldom after cardiac surgery, the digital recording with Thopaz+ can guide the therapy and save cost and time for performing serial chest X-rays.5
  • A recent publication found the incidence of chest X-rays with clamped drains to detect air leaks was significantly lower for patients who were treated with the digital chest drainage system.5
  • Within the group of patients receiving digital chest drainage, a lower proportion of re-thoracotomies due to tamponade/bleeding was also observed.5

3 Saha S, Hofmann S, Jebran AF, et al. Safety and efficacy of digital chest drainage units compared to conventional chest drainage units in cardiac surgery. Interact Cardiovasc Thorac Surg 2020;31(1):42-47.

4 Rathinam S, Bradley A, Cantlin T, et al. Thopaz Portable suction Systems in Thoracic Surgery: An end user assessment and feedback in a tertiary unit. J Cardiothorac Surg 2011;6:59.

5 Van Linden A, Hecker F, Courvoisier DS, et al. Reduction of drainage-associated complications in cardiac surgery with a digital drainage system: a randomized controlled trial. J Thorac Dis 2019;11(12):5177-5186.

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The longer the delay in re-exploration for bleeding
  • Timing is essential: the longer the delay in re-exploration for excessive bleeding post cardiac surgery, the higher the mortality rate.7
  • Bleeding can lead to hemodynamic instability, which requires aggressive therapy.
  • The sooner cardiac patients are re-explored for bleeding and/or tamponade, the higher the survival rate and the shorter the patient’s stay in the hospital.

7 Čanádyová J, Zmeko D, Mokráček A. Re-exploration for Bleeding or Tamponade After Cardiac Operation. Interact Cardiovasc Thorac Surg 2012;14(6):704–7.

  • Continuous, real-time readings and historical chest tube air leak and fluid drainage are displayed in a readable manner on Thopaz+ and allow for improved assessment of chest tube management.
  • The digital data display helps decision makers pinpoint the optimal time for re-operation and chest tube removal.
  • This reduces inter-observer variability in the assessment of these indicators, and facilitates the monitoring of patients’ progress across departments.8
  • The alarms are especially useful in the setting of cardiac surgery when drainage malfunction may be associated with an immediate risk for the patient, i.e. pericardial tamponade.3

 

8 McGuire AL, Petrcich W, Maziak DE, et al. Digital versus analogue pleural drainage phase 1: prospective evaluation of interobserver reliability in the assessment of pulmonary air leaks. Interact Cardiovasc Thorac Surg 2015;21(4):403–7.

3 Saha S, Hofmann S, Jebran AF, et al. Safety and efficacy of digital chest drainage units compared to conventional chest drainage units in cardiac surgery. Interact Cardiovasc Thorac Surg 2020;31(1):42-47.

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  • Studies show that undrained mediastinal blood triggers inflammation, which could be a contributing factor to the development of postoperative atrial fibrillation (POAF) after cardiac surgery.
  • POAF has been linked to longer hospital stays, readmissions and, in some cases, death.
  • The immediate postoperative transfer to ICU is one of the most vulnerable phases after cardiac surgery. During this time adequate drainage of blood is especially important3.

3 Saha S, Hofmann S, Jebran AF, et al. Safety and efficacy of digital chest drainage units compared to conventional chest drainage units in cardiac surgery. Interact Cardiovasc Thorac Surg 2020;31(1):42-47.

 

  • Thopaz+ is a chest drain management solution that provides uninterrupted drainage of the chest cavity immediately after cardiac surgery.
  • Significantly higher blood drainage in the early postoperative course.3,6
  • It is quick and easy to set up, extremely portable and the rechargeable battery allows maximum patient mobility.

3 Saha S, Hofmann S, Jebran AF, et al. Safety and efficacy of digital chest drainage units compared to conventional chest drainage units in cardiac surgery. Interact Cardiovasc Thorac Surg 2020;31(1):42-47.

6 Barozzi L, Biagio LS, Meneguzzi M, et al. Novel, digital, chest drainage system in cardiac surgery. J Card Surg. 2020;35: 1492–1497.

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Prof. Dr. med. Fischlein

"The drainage should be operational as soon as we have sealed the thorax. In many systems, this is not guaranteed, as we need the wall vacuum for it. It can take up to an hour after surgery for the patient to be transferred, arrive at the intensive care unit and for monitoring to be performed. That is a critical stage. Thopaz+, however, guarantees a constant drainage."

Prof. Dr. med. FischleinHead of cardiac surgery department. Klinikum Nürnberg - Paracelsus Medical University
chest drainage

Thopaz+ takes chest drainage therapy to a new level of care. Unlike analogue systems, it reliably regulates the applied pressure at the patient’s chest and digitally (and quietly) monitors critical therapy indicators. Clinical data has demonstrated that Medela’s chest drainage therapy improves outcomes and streamlines the delivery of care.

 

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tubing extension

Silastic tubing extensions allow for flexible drainage system handling:

- connecting 3 catheters to one Thopaz+ device

- Thopaz+ placement at the bed end

- flexible tubing if tubing manipulation is required

silicone cathters

ClotStop® silicone catheters provide a new option for active chest drainage immediately after surgery. The coated surface enhances an effective drainage because clots and exudate don’t adhere to the drain surface. The soft material enhances patient comfort.

 

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Thopaz+ provides safer care for enhanced recovery - after cardiac surgery as well!

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References

1 Pereira KMFSM, de Assis CS, Cintra HNWL, et al. Factors Associated With the Increased Bleeding in the Postoperative Period of Cardiac Surgery: A Cohort Study. J Clin Nurs 2019;28(5–6):850–61.

2 Christensen MC, Krapf S, Kempel A, et al. Costs of Excessive Postoperative Hemorrhage in Cardiac Surgery. J Thorac Cardiovasc Surg 2009;138(3):687–93.

3 Saha S, Hofmann S, Jebran AF, et al. Safety and efficacy of digital chest drainage units compared to conventional chest drainage units in cardiac surgery. Interact Cardiovasc Thorac Surg 2020;31(1):42-47.

4 Rathinam S, Bradley A, Cantlin T, et al. Thopaz Portable suction Systems in Thoracic Surgery: An end user assessment and feedback in a tertiary unit. J Cardiothorac Surg 2011;6:59.

5 Van Linden A, Hecker F, Courvoisier DS, et al. Reduction of drainage-associated complications in cardiac surgery with a digital drainage system: a randomized controlled trial. J Thorac Dis 2019;11(12):5177-5186.

6 Barozzi L, Biagio LS, Meneguzzi M, et al. Novel, digital, chest drainage system in cardiac surgery. J Card Surg. 2020;35: 1492–1497.

7 Čanádyová J, Zmeko D, Mokráček A. Re-exploration for Bleeding or Tamponade After Cardiac Operation. Interact Cardiovasc Thorac Surg 2012;14(6):704–7.

8 McGuire AL, Petrcich W, Maziak DE, et al. Digital versus analogue pleural drainage phase 1: prospective evaluation of interobserver reliability in the assessment of pulmonary air leaks. Interact Cardiovasc Thorac Surg 2015;21(4):403–7.