2 The technology

Description of the technology

2.1 Thopaz+ (Medela UK) is a portable digital chest drain system that provides regulated negative pressure close to the patient's chest and continuously monitors and records air leak and fluid drainage. The system comprises an in-built, regulated suction pump with a digital display, rechargeable battery, tubing that connects to any standard chest drain catheter and a Thopaz+ disposable fluid collection canister. Sensors in the system turn the pump on and off to ensure the pressure level set by the healthcare professional is precisely maintained.

2.2 The rental cost of each Thopaz+ unit, as stated in the company's submission, is £115 per month. It can also be purchased for £3,400.

2.3 The claimed benefits of Thopaz+ in the case for adoption presented by the company are:

  • reduced chest tube duration

  • shorter length of hospital stay

  • reduced rates of patient complications

  • higher patient satisfaction

  • reduced hospital costs

  • increased convenience for doctors and nursing staff

  • improved chest drain management

  • better prediction of patient outcomes

  • less plastic consumable waste.

Current management

2.4 Conventional chest drains use an underwater seal to help drain air and fluid from the pleural space, allowing the lung to re-inflate. This can be done with or without additional wall suction. The NICE guideline on major trauma recommends chest drains for managing chest trauma in pre-hospital and hospital settings, but chest drain management is not specifically covered by NICE guidance.

2.5 The British Thoracic Society guidelines on pleural disease state that chest drains should include a valve mechanism to prevent fluid or air entering the pleural cavity. This may be an underwater seal, flutter valve or other recognised mechanism. Chest drains with underwater seals appear to be standard care in the NHS and consist of a water seal, optional suction control and drainage collection bottle. These drains collect fluid and prevent backflow into the pleural cavity, while at the same time allowing a subjective assessment of air leaks and fluid loss. The drainage bottle must be placed below chest level and kept upright. Suction may sometimes be needed, depending on the patient's condition, and can usually be provided using a wall suction unit.

  • National Institute for Health and Care Excellence (NICE)