Some chest drains may utilize a flutter valve to prevent retrograde flow, but those that do not have physical valves employ a water trap seal design, often aided by continuous suction from a wall suction or a portable vacuum pump.

The active maintenance of an intrapleural negative pressure via chest drains builds the basis of chest drain management, as an intrapleural pressure lower than the surrounding atmosphere allows easier lung expansion and thus better alveolar ventilation and gas exchange.

Sub-atmospheric pressure of around 100 cm of water column was historically generated at a central location in the hospital.

[citation needed] Reduction valves that reduce the negative pressure to a therapeutically reasonable range were commercially available later.

These pumps couldn't compensate for an inadequate position of the collection chamber of a siphon.

The "Heber-Drain" is based on the Heber principle, which uses hydrostatic pressure to transfer fluid from the chest to a collection canister.

The difference in height between the floor and the patient bed determines the resultant sub-atmospheric pressure.

Whether these drains are used with active suction or not depends on factors such as personal preference and experience of the physician, individual patient-related factors etc...[citation needed] Drainage of the pericardium can be achieved by puncture (transcutaneously) or surgically.

It uses either a Heber-drain or an active suction source and comprises a single collection canister.

During the suction process, fluid will be collected in the chamber and air discharged into the atmosphere.