A novel penetrator for preventing tissue structure damage during pleural decompression procedure

A novel penetrator for preventing tissue structure damage during pleural decompression procedure

Shifeng Bai, Mark Fitzgerald, Yesul Kim, Wing Kong Chiu

download PDF

Abstract. Tension pneumothorax(tPTX) refers to air accumulation in the pleural cavity, which is a life-threatening condition. In clinical practice, the intervention is performed when tPTX is suspected. Needle thoracostomy (NT) is the primary treatment recommended by both civil and military guidelines. This is an invasive procedure and is often performed in challenging emergency settings such as the pre-hospital environment. However, it is reported that the effective rate is low. Due to the complexity of the pleural disease, there are several barriers of a successful pleural decompression, such as misdiagnosis, unsuccess treatment and complications of the treatment. One of the problems regarding current instruments used in NT procedure is that the tissue structure could be damaged by the overshoot of the needle-like penetrator. To address this problem, a novel all-in-one device is designed for emergency management of tension pneumothorax. The novel penetrator, which is a sub-assembly of the novel all-in-one device, is aimed at safely penetrating the chest wall and creating a fluid pathway between pleural cavity and ambient air. This research presents the characterization of one safety parameter of the tissue-structure-protection mechanism of the penetrator. In the present study, the mechanism is triggered by a custom-made clipper and the impact force is then measured by an impact hammer. The result shows that the maximum G force generated by the spring-loaded tissue-structure-protection mechanism will not exceed the lung damage threshold found in an animal trial.

Pleural Decompression, Tension Pneumothorax (tPTX), Penetrator, Design

Published online 3/30/2023, 7 pages
Copyright © 2023 by the author(s)
Published under license by Materials Research Forum LLC., Millersville PA, USA

Citation: Shifeng Bai, Mark Fitzgerald, Yesul Kim, Wing Kong Chiu, A novel penetrator for preventing tissue structure damage during pleural decompression procedure, Materials Research Proceedings, Vol. 27, pp 350-356, 2023

DOI: https://doi.org/10.21741/9781644902455-45

The article was published as article 45 of the book Structural Health Monitoring

Content from this work may be used under the terms of the Creative Commons Attribution 3.0 license. Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.

[1] R. W. Light, Pleural diseases. Lippincott Williams & Wilkins, 2007.
[2] S. Paydar, P. Farhadi, and F. Ghaffarpasand, “Advanced trauma life support (atls) tips to be kept in mind,” Bulletin of Emergency & Trauma, vol. 1, no. 1, p. 49, 2013.
[3] F. K. Butler, J. B. Holcomb, S. Shackelford, H. R. Montgomery, S. Anderson, J. S. Cain, H. R. Champion, C. W. Cunningham, W. C. Dorlac, B. Drew, et al., “Management of suspected tension pneumothorax in tactical combat casualty care: Tccc guidelines change 17-02,” Journal of special operations medicine: a peer reviewed journal for SOF medical professionals, vol. 18, no. 2, pp. 19–35, 2018. https://doi.org/10.55460/XB1Z-3BJU
[4] A. Kaserer, P. Stein, H.-P. Simmen, D. R. Spahn, and V. Neuhaus, “Failure rate of prehospital chest decompression after severe thoracic trauma,” The American journal of emergency medicine, vol. 35, no. 3, pp. 469–474, 2017. https://doi.org/10.1016/j.ajem.2016.11.057
[5] M. Fitzgerald, C. Mackenzie, S. Marasco, R. Hoyle, and T. Kossmann, “Pleural decompression and drainage during trauma reception and resuscitation,” Injury, vol. 39, no. 1, pp. 9–20, 2008. https://doi.org/10.1016/j.injury.2007.07.021
[6] M. Fitzgerald, P. Finnegan, W. Chiu, N. Chowdhury, and N. Chowdhury, “Surgical system and method of use,” AU2017363823, 2017.
[7] O. Saphir, “Autopsy diagnosis and technic,” in Autopsy diagnosis and technic, pp. 405–405, 1946.
[8] B. P. Fuhrman, Pediatric critical care. Philadelphia, Pa.: Elsevier Saunders, 4th ed. ed., 2011.