Comments about the CareFusion Pleurx Catheter | Which Medical Device

taking a look to the reviews on this device something turn wrong....let's see if someone could help me to be convinced about:

first indication by reviewer is malignant ascitis, well in which patient. if the pat has to live 1 to 3 weeks I can get a skater pig tail in and the work is done. if the patient has to live 1 to 2 months this may be an indication, but pulling away ascitis is not as throw away water, patient get lose protein and a lot of minerals and thousand of other things that you have to replace in some manner....spending much money than use a littlebit more complex device to install that allows you to preserve such liquids and well maintain your patient "saving money" and making his life better....the device comes from the same manufacturer and allows to transfer ascitis from abdomen to a central vein by a totally implantable system.

any comments?

The PleurX has revolutionised our management of recurrent ascites. Having now done over 30, there is no other palliative procedures we have received expressions of gratitude for. A review of our practice showed an average inpatient stay of 5.5days to drain a median of 4.5l ascites. Slow turn-around due to ward-insertions of pigtail paracentesis by junior staff with experience to make drainage procdeures quicker. Our target patients are those who: 1, had more than one previous conventional paracentesis 2, need more than 1/month 3, are unlikely to have any remianing chemotherapy options to reduce the rate of ascites accumulation Technical tricks: A, Insert from supero-medially to inferolaterally, guiding the catheter into the iliac fossae. This reduces risk of accidental discplacement in the first 3 weeks and ensures the catheter ends up in the lower abdomen. B, Tie the skin exit suture as a purse string around the catheter C, Wear wellies. D, We drain usually 2000ml into a standard drainage bag while putting the sutures in (UK Medical has cheap ones with a luer connector). They are pennies compared to £ 60.- for a one litre vacuum bottle. Organisational aspects: A, The PCT needs to be onboard as they will experience the high consumables cost. However massively outweighed by the lack of future inpatient drainage proedures. B, The district nurses need to be trained prior to patient discharge. UK Medical will do this, but get them onboard early otherwise they might refuse hopital discharge... Commplications Very rare 1, Pain: About 10%, usually self-limiting in the first few days 2, Bleeding: Not seen 3, Delayed loculations (seen on US, not seen on CT): We have seen 2 cases where the ascites ceased to drain after a few weeks, one had an intercurrent skin infection. Both were successfully managed by instillation of streptokinase 250.000 units in 40ml saline and drainage suspended for 1-2 hours. Repeated daily for 4-5days, one patient had one further administration as an outpatient a fortnight later. Both continued successful long-term drainage after that. PleurX has been the simplest procedure with the most clinical impact I have seen. It is also the one that has caused the most heqadaches with the community team.