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Table 14-2

Table 14-2Comparison of Chest Drainage Systems
TypeDescriptionComments
Traditional water seal (also referred to as wet-suction) chamberHas three chambers: a collection chamber, water seal chamber (middle chamber), and wet-suction control chamber. Generally used to provide 20 cm H2O of suction.
  • Requires that sterile fluid be instilled into water seal and suction chambers.
  • Has positive and negative pressure-release valves.
  • Intermittent bubbling indicates that system is functioning properly.
  • Additional suction can be added by connecting system to a suction source.
Dry-suction water seal (also referred to as dry suction)Has three chambers: a collection chamber, water seal chamber (middle chamber), and dry-suction control chamber. Provides up to 40 cm H2O of suction.
  • Requires that sterile fluid be instilled in water seal chamber at 2-cm level.
  • No need to fill suction chamber with fluid.
  • Suction pressure is set with a regulator.
  • Has positive and negative pressure-release valves.
  • Has an indicator to signify that the suction pressure is adequate.
  • Quieter than traditional water seal systems.
Dry-suction (also referred to as one-way valve system)Has a one-way mechanical valve that allows air to leave the chest and prevents air from moving back into the chest
  • No need to fill suction chamber with fluid; can be set up quickly in an emergency.
  • Works even if knocked over, making it ideal for patients who are ambulatory.
  • Not able to easily observe air leaks, monitor intrapleural pressures, or use suction

Source: Adapted from Hinkle, J. L., Cheever, K. H., & Overbaugh, K. J. (2022). Brunner & Suddarth's Textbook of medical-surgical nursing (15th ed.). Wolters Kluwer; Kane, C. J., York, N. L., & Minton, L. A. (2013). Chest tubes in the critically ill patient. Dimensions of Critical Care Nursing, 32(3), 111-117. https://doi.org/1097/DCC.0b013e3182864721; and Sasa, R. I. (2019). Evidence-based update on chest tube management. American Nurse Today, 14(4), 10-14.