BACKGROUND: Malposition of percutaneously inserted chest tubes is considered as a rare complication in critically ill patients. Its incidence, however, remains uncertain. The aims of the study were to assess the true incidence of chest tube malposition in critically ill patients and to identify predicting factors. METHODS: The authors prospectively studied 122 chest tubes percutaneously inserted in 75 consecutive critically ill patients. For clinical reasons independent of the study, thoracic computed tomography scanning was performed in 63 patients, allowing direct visualization of 106 chest tubes. Based on these findings, chest tube position was classified as intrapleural, intrafissural, or intraparenchymal. Factors predicting chest tube malposition were analyzed by univariate and multivariate analysis. RESULTS: The mean delay between chest tube placement and thoracic scan was 3.5+/-2.9 days. Twenty-two chest tubes were diagnosed as being intrafissural (21%), and 10 were diagnosed as being intraparenchymal (9%). The only predicting factor associated with the risk of malposition was the use of a trocar for the percutaneous insertion of the chest tube (P=0.032). CONCLUSIONS: Malposition was detected in 30% of percutaneously inserted chest tubes, a higher incidence than previously reported. Avoiding the use of a trocar may reduce significantly the incidence of chest tube malposition.
BACKGROUND: Malposition of percutaneously inserted chest tubes is considered as a rare complication in critically illpatients. Its incidence, however, remains uncertain. The aims of the study were to assess the true incidence of chest tube malposition in critically illpatients and to identify predicting factors. METHODS: The authors prospectively studied 122 chest tubes percutaneously inserted in 75 consecutive critically illpatients. For clinical reasons independent of the study, thoracic computed tomography scanning was performed in 63 patients, allowing direct visualization of 106 chest tubes. Based on these findings, chest tube position was classified as intrapleural, intrafissural, or intraparenchymal. Factors predicting chest tube malposition were analyzed by univariate and multivariate analysis. RESULTS: The mean delay between chest tube placement and thoracic scan was 3.5+/-2.9 days. Twenty-two chest tubes were diagnosed as being intrafissural (21%), and 10 were diagnosed as being intraparenchymal (9%). The only predicting factor associated with the risk of malposition was the use of a trocar for the percutaneous insertion of the chest tube (P=0.032). CONCLUSIONS: Malposition was detected in 30% of percutaneously inserted chest tubes, a higher incidence than previously reported. Avoiding the use of a trocar may reduce significantly the incidence of chest tube malposition.
Authors: Clemens M Ortner; Kurt Ruetzler; Nikolaus Schaumann; Veit Lorenz; Peter Schellongowski; Ernst Schuster; Ramez M Salem; Michael Frass Journal: Scand J Trauma Resusc Emerg Med Date: 2012-02-02 Impact factor: 2.953
Authors: Manuel F Struck; Sebastian Ewens; Johannes K M Fakler; Gunther Hempel; André Beilicke; Michael Bernhard; Patrick Stumpp; Christoph Josten; Sebastian N Stehr; Hermann Wrigge; Sebastian Krämer Journal: Eur J Trauma Emerg Surg Date: 2018-05-31 Impact factor: 3.693
Authors: Francis Remérand; Jean Dellamonica; Zhang Mao; Fabio Ferrari; Belaïd Bouhemad; Yang Jianxin; Charlotte Arbelot; Qin Lu; Carole Ichaï; Jean-Jacques Rouby Journal: Intensive Care Med Date: 2010-02-06 Impact factor: 17.440
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