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Use of Medela Digital Suction device allows avoidance of Surgery in Sick Patients
Ali Zamir Khan, Shaiwal Khandelwal, Narendra Agarwal, Kamran Ali, Sangeeta Khanna.
Medanta, The Medicity, Gurgaon, India.

OBJECTIVE: We present our experience of facilitation of conservation management of air leaks and malignant pleural effusion by bedside pleurodesis due to use of Medela digital suction suction device thus avoiding surgery and general anesthesia for very sick patients.
METHODS: 52 patients unfit for general anaesthesia underwent bedside Talc pleurodesis for prolonged air leak or malignant pleural effusion. Talc slurry with lignocaine was introduced via the drain and digital suction was applied at 2 Kpas for 48 to 72 hours.
RESULTS: 48/ 52 patients underwent successful talc pleurodesis due to complete lung expansion. 8/46 patient needed 2 doses of talc over 4 days. Early mobilisation was facilitated by portable digital suction device. 2/ 52 patients had small localised apical pneumothorax with no clinical significance. 4 patients with tuberculosis were put on a flutter bag and discharged home. Drain was removed at follow up.
All patients had successful conservative management of clinical problem.
Referral rates have increased from Cardiac surgery, oncology, pulmonology and urology departments specifically seeking medela digital suction device.
CONCLUSIONS: Use of Medela Digital suction device facilitates early expansion of lung and thus aiding in successful bedside talc pleurodesis in very sick patients who are unfit for general anaesthesia.

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