Comparative Study Between a Peristaltic Pump and Vacuum Containers for Paracentesis Management: Time, Flow & Safety

Purpose: Purpose of this study was to make an objective comparison between a peristaltic pump versus vacuum suction containers in the management of paracentesis. The 3 primary variables compared were flow of drained fluid (mL/min), draining time (minutes) and patient safety.

Materials and Methods: This was a non-experimental prospective cohort study comparing data collected during paracentesis with vacuum containers and with a peristaltic pump. Paracentesis was performed in the same manner for all subjects with ultrasound-guidance and trocar technique with a 5 French catheter. The volume drained and time spent draining were recorded real time at the conclusion of the paracentesis. Data was analyzed with chi-square and independent t-test. This study was approved as a quality initiative study by the home institution.

Results: Complete data was collected in 316 paracenteses (157 vacuum, 159 pump) from the 327 consecutive paracenteses performed from 1/3/22 to 8/31/22. There was no significant difference in the baseline characteristics between the groups. The total volume drained and time spent draining in the vacuum group was 767.38 L and 4,356 minutes; and in the pump group: 791.44 L and 2,955 minutes. The average flow in the pump group (287.1 mL/min, SD: 92.4 mL/min, Range: 82.4 to 700 mL/min) was significantly greater (p< 0.0001) than the vacuum group (176.1 mL/min, SD: 55 mL/min, Range 27.3 to 293.8 mL/min). The average time spent draining with the pump (18.6 min, SD: 10.3 min, Range: 2 to 56 min) was significantly less (p < 0.0001) than with the vacuum containers (27.7 min, SD: 14.1 min, Range: 3 to 84 min). No adverse events or episodes of discomfort while draining were encountered in either group. There was no significant difference (p = 0.77) between the average volume drained per paracentesis (vacuum: 4.9 L, pump: 5 L).  The average number of 1.6 L bags used per paracentesis (4 bags, SD: 2, Range: 1 to 8 bags) was significantly less (p < 0.0001) than the average number of 1 L bottles used per paracentesis (6 bottles, SD: 3, Range 1 to 16 bottles).

Conclusion: This objective comparison shows the use of a peristaltic pump has statistically significant faster flow (63% faster), statistically significant shorter time spent draining (33% less), and no differences in patient safety than draining with vacuum containers. While these results are superior operationally and clinically, the financial impact requires further investigation. Specifically, the financial savings in room and staff time need to be weighed against the increased cost of the peristaltic pump, bags and tubing.