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Randomized Clinical Trial of 14-French (14F) Pigtail Catheters versus 28–32F Chest Tubes in the Management of Patients with Traumatic Hemothorax and Hemopneumothorax

INTRODUCTION: Traditional management of traumatic hemothorax/hemopneumothorax (HTX/HPTX) has been insertion of large-bore 32–40 French (Fr) chest tubes (CTs). Retrospective studies have shown 14Fr percutaneous pigtail catheters (PCs) are equally effective as CTs. Our aim was to compare effectiveness...

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Autores principales: Bauman, Zachary M., Kulvatunyou, Narong, Joseph, Bellal, Gries, Lynn, O’Keeffe, Terence, Tang, Andrew L., Rhee, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790482/
https://www.ncbi.nlm.nih.gov/pubmed/33415448
http://dx.doi.org/10.1007/s00268-020-05852-0
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author Bauman, Zachary M.
Kulvatunyou, Narong
Joseph, Bellal
Gries, Lynn
O’Keeffe, Terence
Tang, Andrew L.
Rhee, Peter
author_facet Bauman, Zachary M.
Kulvatunyou, Narong
Joseph, Bellal
Gries, Lynn
O’Keeffe, Terence
Tang, Andrew L.
Rhee, Peter
author_sort Bauman, Zachary M.
collection PubMed
description INTRODUCTION: Traditional management of traumatic hemothorax/hemopneumothorax (HTX/HPTX) has been insertion of large-bore 32–40 French (Fr) chest tubes (CTs). Retrospective studies have shown 14Fr percutaneous pigtail catheters (PCs) are equally effective as CTs. Our aim was to compare effectiveness between PCs and CTs by performing the first randomized controlled trial (RCT). We hypothesize PCs work equally as well as CTs in management of traumatic HTX/HPTX. METHODS: Prospective RCT comparing 14Fr PCs to 28–32Fr CTs for management of traumatic HTX/HPTX from 07/2015 to 01/2018. We excluded patients requiring emergency tube placement or who refused. Primary outcome was failure rate defined as retained HTX or recurrent PTX requiring additional intervention. Secondary outcomes included initial output (IO), tube days and insertion perception experience (IPE) score on a scale of 1–5 (1 = tolerable experience, 5 = worst experience). Unpaired Student’s t-test, chi-square and Wilcoxon rank-sum test were utilized with significance set at P < 0.05. RESULTS: Forty-three patients were enrolled. Baseline characteristics between PC patients (N = 20) and CT patients (N = 23) were similar. Failure rates (10% PCs vs. 17% CTs, P = 0.49) between cohorts were similar. IO (median, 650 milliliters[ml]; interquartile range[IR], 375–1087; for PCs vs. 400 ml; IR, 240–700; for CTs, P = 0.06), and tube duration was similar, but PC patients reported lower IPE scores (median, 1, “I can tolerate it”; IR, 1–2) than CT patients (median, 3, “It was a bad experience”; IR, 3–4, P = 0.001). CONCLUSION: In patients with traumatic HTX/HPTX, 14Fr PCs were equally as effective as 28–32Fr CTs with no significant difference in failure rates. PC patients, however, reported a better insertion experience. www.ClinicalTrials.gov Registration ID: NCT02553434
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spelling pubmed-77904822021-01-08 Randomized Clinical Trial of 14-French (14F) Pigtail Catheters versus 28–32F Chest Tubes in the Management of Patients with Traumatic Hemothorax and Hemopneumothorax Bauman, Zachary M. Kulvatunyou, Narong Joseph, Bellal Gries, Lynn O’Keeffe, Terence Tang, Andrew L. Rhee, Peter World J Surg Original Scientific Report INTRODUCTION: Traditional management of traumatic hemothorax/hemopneumothorax (HTX/HPTX) has been insertion of large-bore 32–40 French (Fr) chest tubes (CTs). Retrospective studies have shown 14Fr percutaneous pigtail catheters (PCs) are equally effective as CTs. Our aim was to compare effectiveness between PCs and CTs by performing the first randomized controlled trial (RCT). We hypothesize PCs work equally as well as CTs in management of traumatic HTX/HPTX. METHODS: Prospective RCT comparing 14Fr PCs to 28–32Fr CTs for management of traumatic HTX/HPTX from 07/2015 to 01/2018. We excluded patients requiring emergency tube placement or who refused. Primary outcome was failure rate defined as retained HTX or recurrent PTX requiring additional intervention. Secondary outcomes included initial output (IO), tube days and insertion perception experience (IPE) score on a scale of 1–5 (1 = tolerable experience, 5 = worst experience). Unpaired Student’s t-test, chi-square and Wilcoxon rank-sum test were utilized with significance set at P < 0.05. RESULTS: Forty-three patients were enrolled. Baseline characteristics between PC patients (N = 20) and CT patients (N = 23) were similar. Failure rates (10% PCs vs. 17% CTs, P = 0.49) between cohorts were similar. IO (median, 650 milliliters[ml]; interquartile range[IR], 375–1087; for PCs vs. 400 ml; IR, 240–700; for CTs, P = 0.06), and tube duration was similar, but PC patients reported lower IPE scores (median, 1, “I can tolerate it”; IR, 1–2) than CT patients (median, 3, “It was a bad experience”; IR, 3–4, P = 0.001). CONCLUSION: In patients with traumatic HTX/HPTX, 14Fr PCs were equally as effective as 28–32Fr CTs with no significant difference in failure rates. PC patients, however, reported a better insertion experience. www.ClinicalTrials.gov Registration ID: NCT02553434 Springer International Publishing 2021-01-07 2021 /pmc/articles/PMC7790482/ /pubmed/33415448 http://dx.doi.org/10.1007/s00268-020-05852-0 Text en © Société Internationale de Chirurgie 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Scientific Report
Bauman, Zachary M.
Kulvatunyou, Narong
Joseph, Bellal
Gries, Lynn
O’Keeffe, Terence
Tang, Andrew L.
Rhee, Peter
Randomized Clinical Trial of 14-French (14F) Pigtail Catheters versus 28–32F Chest Tubes in the Management of Patients with Traumatic Hemothorax and Hemopneumothorax
title Randomized Clinical Trial of 14-French (14F) Pigtail Catheters versus 28–32F Chest Tubes in the Management of Patients with Traumatic Hemothorax and Hemopneumothorax
title_full Randomized Clinical Trial of 14-French (14F) Pigtail Catheters versus 28–32F Chest Tubes in the Management of Patients with Traumatic Hemothorax and Hemopneumothorax
title_fullStr Randomized Clinical Trial of 14-French (14F) Pigtail Catheters versus 28–32F Chest Tubes in the Management of Patients with Traumatic Hemothorax and Hemopneumothorax
title_full_unstemmed Randomized Clinical Trial of 14-French (14F) Pigtail Catheters versus 28–32F Chest Tubes in the Management of Patients with Traumatic Hemothorax and Hemopneumothorax
title_short Randomized Clinical Trial of 14-French (14F) Pigtail Catheters versus 28–32F Chest Tubes in the Management of Patients with Traumatic Hemothorax and Hemopneumothorax
title_sort randomized clinical trial of 14-french (14f) pigtail catheters versus 28–32f chest tubes in the management of patients with traumatic hemothorax and hemopneumothorax
topic Original Scientific Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790482/
https://www.ncbi.nlm.nih.gov/pubmed/33415448
http://dx.doi.org/10.1007/s00268-020-05852-0
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