Back to the 60s: The Heimlich Valve A patient- and family-centered care perspective

Abstract

In this case report we present a 5-year old boy with a bronchopleural fistula with persistent air leak following complicated empyema. Treatment with antibiotics and pleural drainage did not stop the air leak and consequently prolonged drainage of the pleural cavity was needed. As this would account for weeks of hospitalization, we decided together with the parents, following the main principles of Patient-and-Family Centered Care, to treat the child at home with the use of a Heimlich valve. A Heimlich valve may be an old-fashioned, but effective one-way-valve permitting evacuation of air and fluid from the thoracic cavity without the need of high technology solutions and with minimal risk to the patient. This may prevent prolonged hospitalization, increase quality of life of the patient and save medical costs.After 2 months the chest tube with Heimlich valve was successfully removed. Recovery was uneventful; long term follow up showed restricted lung function with a total lung capacity of around 78% and fibrotic changes of the right upper lobe on chest CT scan.

Keywords

• Varicella pneumonia
• Bronchopleural fistula
• Persistent air leak
• Heimlich valve
• Patient-and-family centered care