• Udo Anegg, Jorg Lindenmann, Veronika Matzi, Dzenana Mujkic, Alfred Maier, Lukas Fritz, and Freyja Maria Smolle-Jüttner.
• Division of Thoracic and Hyperbaric Surgery, University Medical School, Auenbruggerplatz 29, A-8036 Graz, Austria. udo@anegg.net
• Eur J Cardiothorac Surg. 2006 Jun 1; 29 (6): 867-72.

ObjectiveProlonged air leak after pulmonary resection is a common complication and a major limiting factor for early discharge from hospital. Currently there is little consensus on its management. The aim of this study was to develop and evaluate a measuring device which allows a simple digital bed-side quantification of air-leaks compatible to standard thoracic drainage systems.Patients And MethodsThe measuring device (AIRFIX) is based upon a 'mass airflow' sensor with a specially designed software package that is connected to a thoracic suction drainage system. Its efficacy in detecting pulmonary air-leaks was evaluated in a series of 204 patients; all postoperative measurements were done under standardized conditions; the patients were asked to cough, to take a deep breath, to breathe out against the resistance of a flutter valve, to keep breath and to breathe normally. As standard parameters, the leakage per breath or cough (ml/b) as well as the leakage per minute (ml/min) were displayed and recorded on the computer.ResultsAir-leaks within a range of 0.25-45 ml/b and 5-900 ml/min were found. Removal of the chest tubes was done when leakage volume on Heimlich valve was less than 1.0 ml/b or 20 ml/min. After drain removal based upon the data from chest tube airflowmetry none of the patients needed re-drainage due to pneumothorax.ConclusionThe AIRFIX device for bed-side quantification of air-leaks has proved to be very simple and helpful in diagnosis and management of air-leaks after lung surgery, permitting drain removal without tentative clamping.

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