Novel dual-lumen drainage catheter to enhance active evacuation of complex fluid collections.

PURPOSE To compare the performance of a dual-lumen flushable drainage catheter to a conventional catheter for drainage of complex fluid collections. MATERIALS/METHODS Two prototype catheters (20- and 28-French) were created by incorporating a customized infusion lumen within the wall of a large-bore conventional drainage catheter, which facilitated simultaneous irrigation of the drainage lumen and the targeted collection via inward- and outward-facing infusion sideholes. These were tested against unaltered 20- and 28-French conventional catheters to determine if injection of the dedicated flush lumen improved rapidity and completeness of gravity drainage. In vitro models were created to simulate serous fluid, purulent/exudative fluid, particulate debris, and acute hematoma. RESULTS In the purulent model, mean drainage rate was 19.9±8.0 mL/min for the 20-Fr prototype versus 9.5±1.4 mL/min for the control (p<0.001), and 63.9±4.3 mL/min for the 28-Fr prototype versus 35.4±3.4 mL/min for the control (p=0.006), with complete drainage achieved in all trials. In the particulate model, mean drainage rate was 24.5±9.7 mL/min for the 28-Fr prototype versus 12.0±12.5 mL/min for the control (p=0.003), with 69.0% versus 41.1% total drainage achieved over 24 minutes (p=0.029). In the hematoma model, mean drainage rate was 22.7±4.6 mL/min for the 28-Fr prototype versus 4.8±4.3 mL/min for the control (p=0.022), with 80.3% versus 20.1% drainage achieved over 15 minutes (p=0.003). Particulate and hematoma 20-Fr prototype and conventional trials failed due to immediate occlusion. CONCLUSION The proposed dual-lumen drainage catheter with irrigation of a dedicated flush lumen improved evacuation of complex fluid collections in vitro.