Karen E Dull1, Gary R Fleisher. 1. Division of Emergency Medicine, Children's Hospital, Boston, MA, USA. Karen.Dull@TCH.Harvard.edu
Abstract
OBJECTIVE: We sought to compare the efficacy (pneumothorax resolution and hospitalization days), pain (narcotic usage), and safety (need for repositioning or replacement) associated with placement of large-bore chest tubes versus pigtail catheters in children with pneumothoraces. METHODS: We conducted a retrospective chart review of all patients with pneumothoraces seen in the emergency department (ED) over a 6.5-year period who received treatment by a pediatric emergency physician with either a large-bore chest tube or a pigtail catheter. We excluded patients who had catheters placed by other specialists and patients who were endotracheally intubated. We collected the following data: complications, hospital days to discharge, and narcotic pain medications taken. RESULTS: Eleven pigtail catheters and 16 large-bore chest tubes were placed. All pneumothoraces were effectively evacuated. Three of the 11 pigtail catheters required repositioning, and one was replaced. Two of the 16 large-bore chest tubes were repositioned, and one was replaced; additionally, a pigtail catheter was added to one patient with a large-bore chest tube to facilitate evacuation of the air. Average hospital stay was similar between groups (6.2 d for pigtail catheters vs 6.8 d for large-bore chest tubes, = 0.74). Children with pigtail catheters required less narcotic pain medications than those who had large-bore chest tubes, but the differences were not significant. CONCLUSION: Pigtail catheters offer a safe and effective alternative to large-bore chest tubes for patients receiving treatment for pneumothoraces in the ED.
OBJECTIVE: We sought to compare the efficacy (pneumothorax resolution and hospitalization days), pain (narcotic usage), and safety (need for repositioning or replacement) associated with placement of large-bore chest tubes versus pigtail catheters in children with pneumothoraces. METHODS: We conducted a retrospective chart review of all patients with pneumothoraces seen in the emergency department (ED) over a 6.5-year period who received treatment by a pediatric emergency physician with either a large-bore chest tube or a pigtail catheter. We excluded patients who had catheters placed by other specialists and patients who were endotracheally intubated. We collected the following data: complications, hospital days to discharge, and narcotic pain medications taken. RESULTS: Eleven pigtail catheters and 16 large-bore chest tubes were placed. All pneumothoraces were effectively evacuated. Three of the 11 pigtail catheters required repositioning, and one was replaced. Two of the 16 large-bore chest tubes were repositioned, and one was replaced; additionally, a pigtail catheter was added to one patient with a large-bore chest tube to facilitate evacuation of the air. Average hospital stay was similar between groups (6.2 d for pigtail catheters vs 6.8 d for large-bore chest tubes, = 0.74). Children with pigtail catheters required less narcotic pain medications than those who had large-bore chest tubes, but the differences were not significant. CONCLUSION: Pigtail catheters offer a safe and effective alternative to large-bore chest tubes for patients receiving treatment for pneumothoraces in the ED.
Authors: Raffaella Panza; Giorgia Prontera; Kevin Nicholas Ives; Sanja Zivanovic; Charles C Roehr; Michele Quercia; Federico Schettini; Francesco Paolo Bianchi; Silvio Tafuri; Antonio Di Mauro; Nicola Laforgia Journal: Eur J Pediatr Date: 2019-10-26 Impact factor: 3.183