How do I set up the Ocean drain for “balanced drainage” for pneumonectomy patients?
With balanced pneumonectomy drainage no suction is connected and the suction control stopcock should remain open. Also the suction control chamber does not need to be filled. The water seal is filled to the 1cm level, instead of the normal 2cm. The depth of the water in the water seal determines the maximum amount of positive pressure in the chest. With a 1cm water seal, the maximum amount of positive pressure is +1cmH2O. With a 1cm water seal, pleural negativity can not exceed approximately -17cmH2O. If patient intrathoracic pressure begins to increase to approximately -17cmH2O, air at a lesser negative pressure will pass through the water seal and enter the pleural space. This will reduce the negative pressure in the pleural space.
