Adverse events related to thoracentesis and chest tube insertion: evaluation of the national collection of subject safety incidents in Japan

British Thoracic Society Clinical Statement on pleural procedures

“…[76][77][78][79] Mortality directly related to chest drain insertion is related to either the occurrence of RPO or organ puncture. 80 Fortunately, mortality is rare and has not been encountered in large series by Jackson et al 76 and Kong et al, 81 but a mortality rate of 0.1% was reported in the 2015 BTS Pleural procedures and patient safety audit. 49 Many of the serious complications involving organ damage have been reported in procedures where the 'trocar technique' was used.…”

Outcomes of Pigtail Catheter Placement versus Chest Tube Placement in Adult Thoracic Trauma Patients: A Systematic Review and Meta-Analysis

“…23 For traumatic pneumothoraces in patients who were hemodynamically unstable, if using an open technique, small-bore chest tubes such as a 20-28Fr or percutaneous pigtail tubes were recommended, whereas hemodynamically stable patients with large pneumothoraces (>35 mm on CT or >20% on CXR) could use even smaller pigtail catheters if the pneumothorax was isolated. 29 As there is a relative lack of data on hemodynamically unstable patients requiring tube thoracostomy compared to the literature on those who are hemodynamically stable, EAST, WTA, and other trauma societies should further evaluate the use of pigtail catheters in a wider variety of situations of hemodynamically unstable patients to better support these guidelines. 22,27,28…”

“…Previous literature has looked at chest tube size related to mortality and the use of larger-bore tubes for severe thoracic injuries, although it lacks epidemiology data to indicate the adverse events associated with mortality. 29,30 Thus, these studies may wish to include inpatient mortality as an outcome evaluated in their study design, as there is a paucity of data surrounding the effectiveness of these treatment modalities on mortality. Additionally, although no difference in failure rates was found in this study, future studies should further evaluate this relationship, as variable results have been demonstrated in the current body of literature.…”

“…7 Despite these favorable outcomes associated with pigtail catheters, existing studies have demonstrated their use primarily in hemodynamically stable patients suffering blunt injuries, with minimal data surrounding their utility in patients who are hemodynamically unstable or suffering penetrating thoracic trauma. 4,8,9 Although these studies detail improved patient experiences when using pigtail catheters over a traditional chest tube, the 10th edition of the ATLS guidelines continues to suggest the use of larger [28][29][30][31][32] Fr chest tubes as a treatment for major thoracic injuries such as hemothoraces. 10 As such, further research comparing trauma-related patient outcomes is necessary to elucidate the benefits and risks of pigtail catheter utilization compared to chest tubes in the management of thoracic trauma.…”