Bottle 1
  • No water prime and acts purely as a collection reservoir for fluid
  • Air from the pleural cavity passes into the second bottle
Bottle 2
  • Has an underwater seal with tubing tip 2-3cm below the water
  • Acts as a one way valve as in a classic one chamber system
Bottle 3
(Not Always Required)
  • Exists to provide and control negative pressure suction to the system
  • 3 tubes attach to the top:
    • First connects to bottle 2
    • Second connects to the suction pump
    • Third connects to the atmosphere and water prime, and controls the magnitude of suction
  • Suction is applied to the bottle making the pressure more negative and entraining air from the second bottle
  • The degree of suction is controlled by the depth of the 3rd tube in the water prime. If it is set to 10cm below the water, no more than - 10cm H2O of pressure can be applied to the bottle as below this air will be entrained from the atmosphere and will be seen bubbling through the water prime
Three-bottle chest drain system