Improving outcomes and streamlining care – clinically proven

Thopaz+ Digital Chest Drainage and Monitoring System

Follow the innovative path of chest drainage
chest-drain-dysfunction-is-a-common-but-serious-clinical-problem
  • Wall suction in hospitals does not always provide reliable pressure. Clinicians sometimes even note that the dials can fluctuate.1
  • Setting the pressure correctly with underwater seal drains can be difficult:
    • With wet underwater seal drains, air flow increases with wall suction level, but the negative pressure becomes unstable because of water loss.2
    • Dry systems increase the air flow without modifying the regulator pressure.2
    • Single-chamber systems raise the air flow but increase the negative pressure.2
  • The degree of negative pressure applied to the patient in traditional drainage varies depending on several factors, including:
    • The amount of fluid in the tube.3
    • Uncontrolled siphoning effects within the chest tube.4
    • A column of fluid advancing downward along the chest tube may increase resistance and in turn, increase the pleural pressure.5
    • The elevation of the device relative to the patient.3, 4
  • Common problems of underwater seal drains include inadequate priming, kinked tubes, and overfilled bottles.6

1 Danitsch D. Benefits of Digital Thoracic Drainage Systems. Nurs times 2012;108(11):16–7.
2 Manzanet G, Vela A, Corell R, et al. A Hydrodynamic Study of Pleural Drainage Systems: Some Practical Consequences. Chest 2005;127(6):2211–21.
3 Aguayo E, Cameron R, Dobaria V et al. Assessment of differential pressures in chest drainage systems: Is what you see what you get? J Surg Res 2018;232: 464–9.
4 Refai M, Brunelli A, Varela G, et al. The Values of Intrapleural Pressure Before the Removal of Chest Tube in Non-Complicated Pulmonary Lobectomies. Eur J Cardiothorac Surg 2012;41(4):831–3.
5 Brunelli A, Salati M, Pompili C, et al. Regulated Tailored Suction vs Regulated Seal A Prospective Randomized Trial on Air Leak Duration. Eur J Cardiothorac Surg 2013;43(5):899–904.
6 Hashmi U, Nadeem M, Aleem A, et al. Dysfunctional Closed Chest Drainage – Common Causative Factors and Recommendations for Prevention. Cureus 2018;10(3):e2295.

thoapz-plus-provides-a-reliable-and-safe-drainage-therapy
  • Thopaz+ provides stable negative pressure without the influence of position changes or obstruction of tubing.
  • The Thopaz+ double lumen tubing measures and regulates set pressure close to the patient's chest. In case of obstruction, the tubing is cleared with short air flushing sequences and alarms are triggered if the blockage cannot be cleared.
  • Thopaz+ alerts if patient's safety is at risk, such as kinking of the tubing, full canister, low battery status.
  • Its backflow valve prevents air or fluids from returning to the patient (even if the battery is depleted or the device stops running).
  • Thopaz+ is easy to set up, user friendly, and does not require priming.7

Find out more about the advantages of Thopaz+ from an ICU nurse: https://www.medelahealthcare.com/insights/demystifying-chest-drainage-systems

 

7 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.

Reduce chest drainage associated complications with Thopaz+

Discover how
inaccurate-data-and-high-interobserver-variability-2
  • Management of pulmonary air leak is a significant clinical challenge for all chest surgeries.
  • With underwater seal drains, a timely detection, objective quantification, sizing, and trending of pulmonary air leaks are all difficult to achieve.8
  • A high level of disagreement exists among doctors on when to remove chest drains.9 Even experienced observers often disagree not only on the size or clinical importance of a leak but sometimes whether one exists or not.10
  • The incidence of prolonged air leak (PAL, defined as air leak > 5 days) after pulmonary resection can be as high as 25%.11 PAL remains a frequent complication that can lead to more severe morbidities, such as empyema, and prolongs the need for chest tubes and hospitalization.12
  • Identifying the predictors of PAL may be clinically useful for taking additional measures to prevent this complication and reduce medical expenditure.12

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.
9 Varela G, Jiménez MF, Novoa NM, et al. Postoperative chest tube management: measuring air leak using an electronic device decreases variability in the clinical practice. Eur J Cardiothorac Surg 2009;35(1):28–31.

10 Cerfolio RJ, Varela G, Brunelli A. Digital and Smart Chest Drainage Systems to Monitor Air Leaks: The Birth of a New Era? Thorac Surg Clin 2010;20(3):413–20.
11 Liberman M, Muzikansky A, Wright CD, et al. Incidence and Risk Factors of Persistent Air Leak After Major Pulmonary Resection and Use of Chemical Pleurodesis. Ann Thorac Surg 2010;89(3):891–8.
12 Brunelli A, Monteverde M, Borri A, et al. Predictors of Prolonged Air Leak After Pulmonary Lobectomy. Ann Thorac Surg 2004;77(4):1205–10

thopazplus-display-and-trending-data-are-crucial-to-staff-comms-2
  • Continuous, real-time readings and historical trend data on air leaks and drainage are displayed comprehensibly and allow for improved chest tube management.
  • This reduces interobserver variability and facilitates monitoring of the patient’s progress across departments.8
  • Digital monitoring of peak air leakage and patterns of air leakage can be useful for predicting prolonged air leak after pulmonary resection.13
  • The digital data display helps decision-makers pinpoint the optimal time for chest tube removal.

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.
13 Takamochi K, Imashimizu K, Fukui M, et al. Utility of Objective Chest Tube Management After Pulmonary Resection Using a Digital Drainage System. Ann Thorac Surg 2017;104:275–83.

alansihoe_eacts

"What was shown in China in Hong Kong over and over again, is we're reducing interobserver discrepancy between readings. Very often, our nurses or residents will do a ward round, they'll have a look at the water seal chest drain. Is it leaking? And they're not sure. A resident says, "Yes," then a nurse comes around five minutes later, who says, "No." Who do you believe? And very often, we just err on the side of caution, to leave the chest drain in another day. So, by reducing interobserver discrepancy, we're getting more concordance, and better, decision making in removing drain. That often saves a whole day of chest drainage duration."

Alan SihoeHonorary Consultant in Cardiothoracic Surgery Gleneagles Hong Kong Hospital, International Medical Centre, Hong Kong, China

Thopaz+ enables data-based decision making

Empower your team
bed-rest-is-associated-with-increased-risks-and-complications
  • Bed rest is associated with:
    • Decline in physical condition.
    • Diminished muscle mass.
    • Increased pulmonary complications (atelectasis and pneumonia).
    • Increased risk of VTE (venous thromboembolism).14
  • Barriers, such as chest tubes connected to wall suction, decrease the ability of early patient mobilization. So, it is important to manage these parameters well.14

14 Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for Enhanced Recovery After Lung Surgery: Recommendations of the Enhanced Recovery After Surgery (ERAS®) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg 2018;55(1):91–115.

  • Thanks to its lightweight, compact design, Thopaz+ helps mobilize patients at an early stage.
  • While mobilizing, therapy continues: The integrated suction source with a long-life battery means, patients can move independently of wall suction in hospitals and can be transported with ease while effective drainage takes place.
  • With Thopaz+ there is no need to disconnect/reconnect to enable mobilization - this decreases infection risks.7
  • ERAS guidelines14 recommend mobilizing patients early to counteract the range of complications associated with immobilization.
    Read more about it here: https://www.medelahealthcare.com/insights/eras-guidelines-in-thoracic-surgery.

7 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.
14 Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for Enhanced Recovery After Lung Surgery: Recommendations of the Enhanced Recovery After Surgery (ERAS®) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg 2018;55(1):91–115.

Start early mobilization in intensive care with Thopaz+

Find out how
  • Transport of patients for CT scans and other procedures is a necessary part of post-operative care, posing a considerable danger for the patient. The sicker the patient, the higher the risk of complications.15
  • Even harmless situations may hide extensive dangers. Chest drains are sometimes clamped during transfer to the radiology department or between units. This can turn a simple pneumothorax into a life-threatening situation.16
  • Although clamping a chest drain when transporting the patient is dangerous, it is still common practice.16

15 Day D. Keeping Patients Safe During Intrahospital Transport. Crit Care Nurs 2010;30(4):18–32.
16 Al-Tarshihi MI, Khamash FA, Ellatif A. Thoracostomy tube complications and pitfalls: An experience at a tertiary level military hospital. Rawal Med J 2008;33(2).

thopazplus-simplifies-patient-transport-2
  • The use of Thopaz+ ensures safe and continuous drainage during transport.
  • The integrated suction source means patients receive effective drainage wherever they are (during transport, on the ICU, or ward).
  • The lightweight, compact, and battery-operated Thopaz+ goes with the patient.
  • Thanks to its double lumen tubing, Thopaz+ maintains the set pressure and provides safe therapy even if the device is at patient level. 17

17 Zhou J, Lyu M, Chen N, et al. Digital chest drainage is better than traditional chest drainage following pulmonary surgery: a meta-analysis. E J Cardiothorac Surg 2018;54(4):635–43.

Mitigate risks with continuous drainage

Find out more
Chest Tube Bubbling
  • Noise is an important factor to consider when treating patients.
  • Studies conducted in ICUs show that patient anxiety increased during “noisy” periods, defined as periods of noise greater than 55 dB(A).18
  • A chest tube bubbling has the intensity of up to 86 dB(A).19
  • For clinical staff, noise can make it harder to carry out complex tasks, reduces accuracy and inhibits the capacity to respond to unexpected events.19

18 Hsu T, Ryherd E, Waye KP, et al. Noise Pollution in Hospitals: Impact on Patients. Journal of Clinical Outcome Management 2012;19(7):301–9.
19 Kam PC, Kam AC, Thompson JF. Noise Pollution in the Anaesthetic and Intensive Care Environment. Anaesthesia 1994;49(11):982–6.

Thopaz+ operates quietly
  • Thopaz+ provides silent suction only when required to maintain the set pressure, keeping noise levels to a minimum.
  • The low sound level is ideal for ICU nurses and patients alike.
  • Patients prefer the lack of bubbling noise and the compactness over conventional drains and suction.7
  • In a survey of postoperative chest drain-specific patient outcomes, patients treated with Thopaz+ returned higher scores across all 20 questions.20

7 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.
20 Sihoe A, Fang V, Liu L, et al. 2019.Objective and patient-reported outcomes after lung resection surgery are improved by digital chest drainage systems compared to traditional water seal systems: Results from a prospective multicenter database in China. Poster presented at ESTS 2019, Dublin.

Eliminate "bubbling" noise and stress

Learn about quiet care
nursing-crisis-and-fluctuation-2
  • The shortage of nursing staff is one of the biggest problems in healthcare, one that affects hospitals worldwide.21
  • Job dissatisfaction is reported as a major factor in nurse turnover.22
  • Excess workload and issues in interpersonal relationships are the main reasons nurses consider leaving their jobs.21
  • Efforts to make daily work of nurses easier may have a positive impact on staff satisfaction.7, 21

7 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.
21 Hayes LJ, O’Brien-Pallas L, Duffield C, et al. Nurse Turnover: A Literature Review – An Update. Int J Nurs Stud 2012;49(7):887–905.
22 Kalisch B, Lee H, Rochman M. Nursing Staff Teamwork and Job Satisfaction. J Nurs Manag 2010;18(8):938–47.

nurses-prefer-using-thopazplus-for-chest-drain-management
  • 80% of ICU nurses say they would rather work with digital than analog devices.23
  • Managing patients with Thopaz+ is easier than with conventional chest drains and this may release nurse time.24
  • By providing digital data on air leak and fluid drainage in real-time and as a trend, Thopaz+ facilitates the assessment of the patient's progress and communication.8
  • Nurses appreciate Thopaz+ because:
    • It facilitates standardized management of chest tubes.25
    • On-screen graphs and alarms make management safer and air leak assessment more accurate.7
    • The canisters are sealed dry units. ICU nurses don’t need to prime them, which reduces the risk of spillage and infection.7
    • Thopaz+ clears the device's tubing connected to the inter-costal drain to prevent blockage.14
    • The introduction to clinical practice of Thopaz+ to manage chest tubes has a short learning curve.26
  • Find out more about the advantages of Thopaz+ from an ICU nurse: https://www.medelahealthcare.com/insights/demystifying-chest-drainage-systems

7 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.
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.
14 Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for Enhanced Recovery After Lung Surgery: Recommendations of the Enhanced Recovery After Surgery (ERAS®) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg 2018;55(1):91–115.
23 Mier JM, Molins L, Fibla JJ. The benefits of digital air leak assessment after pulmonary resection: prospective and comparative study. Cir Esp 2010;87(6):385–9.
24 National Institute for Health Excellence. Thopaz+ portable digital system for managing chest drains. Medical technologies guidance [MTG37]. 2018. Internet: https://www.nice.org.uk/guidance/MTG37 (downloaded on 21.01.2019).
25 Geroge RS, Papagiannopoulos K. Advances in chest drain management in thoracic disease. J Thorac Dis 2016;8(Suppl 1): S55–S64.
26 Pompili C, Brunelli A, Salati M, et al. Impact of the learning curve in the use of a novel electronic chest drainage system after pulmonary lobectomy: a case-matched analysis on the duration of chest tube usage. Interact Cardiovasc Thorac Surg 2011;13(5):490–3.

Thopaz+ makes daily nursing work easier

Empower your team
  • Air leakage is considered as the most common cause of prolonged hospitalization after pulmonary resection.27
  • Underwater seal drainage systems rely on doctors and nurses to check for air bubbles that indicate air leaks.8
  • Subjectively grading air leaks and observer variability does not allow for standardization of chest drain management.
  • Inaccuracy or errors in the air leak assessment occur and have the potential to lead to suboptimal patient outcomes, such as premature removal of chest drains and subsequent need for drain reinsertion and/or prolonged hospitalization.8

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.
24 National Institute for Health Excellence. Thopaz+ portable digital system for managing chest drains. Medical technologies guidance [MTG37]. 2018. Internet: https://www.nice.org.uk/guidance/MTG37 (downloaded on 21.01.2019).
27 eComment. Air Leak: The Importance of Being Consistent. Interact Cardiovasc Thorac Surg 2015;21(4):408.

upgrade-your-chest-drains-to-thopazplus-and-save-costs-2
  • Thopaz+ improves clinical decision-making through continuous objective monitoring of air leaks and drainage, thus promoting early chest tube removal.26,  29
  • Thopaz+ reduces hospital stays by up to 1.5 days compared with conventional wall suction powered chest drainage.26, 28, 29
  • Analyses showed:
    • Using Thopaz+ after pulmonary resection can result in cost savings of £111.33 per patient.24
    • Using Thopaz+ for the treatment of pneumothorax can result in cost savings of £550.90 per patient.29
    • These savings add up! At a national level in England the NICE resource impact assessment shows that adopting Thopaz+ is expected to save around £8.5 million per year.24

24 National Institute for Health Excellence. Thopaz+ portable digital system for managing chest drains. Medical technologies guidance [MTG37]. 2018. Internet: https://www.nice.org.uk/guidance/MTG37 (downloaded on 21.01.2019).
26 Pompili C, Brunelli A, Salati M, et al. Impact of the learning curve in the use of a novel electronic chest drainage system after pulmonary lobectomy: a case-matched analysis on the duration of chest tube usage. Interact Cardiovasc Thorac Surg 2011;13(5):490–3.
28 Pompili C, Detterbeck F, Papagiannopoulos K, et al. Multicenter International Randomized Comparison of Objective and Subjective Outcomes Between Electronic and Traditional Chest Drainage Systems. Ann Thorac Surg 2014;98(2):490–7.
29 Evans JM, Ray A, Dale M, et al. Thopaz+ portable digital system for managing chest drains: A NICE Medical Technology Guidance. Appl Health Econ Health Policy 2019;17(3):285–94.

ericlim_eacts

"Drains can be safely managed on protocol. Mine is simple. I use Thopaz+ and take the drain out if the air leak is less than 20 ml/min in the last 6 hours without regard to fluid volume (except blood and chyle). Our data suggests that approximately 90% of my patients have their drains removed on day one which improves patient mobility, pain, satisfaction and saves costs for the hospital."

Eric LimConsultant Thoracic Surgeon at the Royal Brompton Hospital and Professor of Thoracic Surgery at Imperial College London, UK

Find out how Thopaz+ shortens hospital stays and reduces costs

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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.

  • Thopaz+ reduces chest tube duration and length of stay (in hospital).
  • Improves safety for people with chest drains.
  • Improves clinical decision-making through continuous objective monitoring of air leaks and fluid loss.
  • Increases patient mobility.
  • Clinical staff find Thopaz+ more convenient and easier to use than conventional chest drainage systems.
  • Visit our FAQ for more information about safe chest drain management.