Indwelling Small Pleural Catheter Needle Thoracentesis in the Management of Large Pleural Effusions

Grodzin, Charles J.; Balk, R.A.

doi:10.1378/chest.111.4.981

Cited by 57 publications

(27 citation statements)

References 5 publications

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“…Grodzin and Balk [21] demonstrated that the use of a small indwelling pleural catheter was more cost-effective when used in place of a closed tube thoracostomy for drainage of large-volume pleural effusions.…”

Section: Discussionmentioning

confidence: 99%

Pigtail Catheter Use for Draining Pleural Effusions of Various Etiologies

Bediwy

Amer

2012

ISRN Pulmonology

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Background. Use of small-bore pigtail catheter is a less invasive way for draining pleural effusions than chest tube thoracostomy. Methods. Prospectively, we evaluated efficacy and safety of pigtail catheter (8.5-14 French) insertion in 51 cases of pleural effusion of various etiologies. Malignant effusion cases had pleurodesis done through the catheter. Results. Duration of drainage of pleural fluid was 3-14 days. Complications included pain (23 patients), pneumothorax (10 patients), catheter blockage (two patients), and infection (one patient). Overall success rate was 82.35% (85.71% for transudative, 83.33% for tuberculous, 81.81% for malignant, and 80% for parapneumonic effusion). Nine cases had procedure failure, five due to loculated effusions, and four due to rapid reaccumulation of fluid after catheter removal. Only two empyema cases (out of six) had a successful procedure. Conclusion. Pigtail catheter insertion is an effective and safe method of draining pleural fluid. We encourage its use for all cases of pleural effusion requiring chest drain except for empyema and other loculated effusions that yielded low success rate.

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Section: Discussionmentioning

confidence: 99%

Pigtail Catheter Use for Draining Pleural Effusions of Various Etiologies

Bediwy

Amer

2012

ISRN Pulmonology

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“…For these reasons, the utilization of small-bore catheters for prolonged inpatient and/or outpatient drainage of MPEs has been advocated in a number of case reports [17, 18, 19, 20]. These early descriptions contributed to the development of a small-bore, flexible, tunneled pleural catheter (PC) that allows for periodic home drainage of MPEs.…”

Section: Introductionmentioning

confidence: 99%

Outpatient Management of Malignant Pleural Effusions with Small-Bore, Tunneled Pleural Catheters

et al. 2004

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Background: Malignant pleural effusions (MPEs) can produce significant respiratory symptoms and diminished quality of life in patients with terminal malignancies. Control of MPEs to palliate respiratory symptoms can be performed via several different approaches. Ideally, a minimally invasive procedure to control MPEs and to provide relief of respiratory symptoms would be optimal. Objective: To ascertain if control of MPEs can be achieved by outpatient management via a small-bore pleural catheter (PC) without the need for sclerosing agents. Methods: Retrospective chart analysis of 24 patients after outpatient insertion of PCs for recurrent, symptomatic MPEs followed by frequent home drainage of pleural fluid to relieve respiratory symptoms. Results: Symptomatic relief of respiratory symptoms was achieved in 100% of patients, while pleurodesis was achieved in 58% of patients in a mean of 39 days. Five patients (6 PCs) expired with the catheters in place. In these patients, all catheters remained in position and functional until the patients ultimately died from nonpleural disease progression. No major complications occurred during insertion of the catheter. Late complications included localized cellulitis and bacterial superinfection in three patients and tumor growth at the catheter site in one patient. Conclusions: The PCs used in the present study provided an effective modality not only to alleviate respiratory symptoms associated with MPE, but also to achieve pleurodesis in 58% of our patients. These catheters may provide a significantly less invasive outpatient approach to the palliative management of MPEs.

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“…They found that these small-caliber catheters had a performance similar to large-caliber tubes, but with substantially reduced pain levels. The advantages of small-caliber catheters have subsequently been confirmed in numerous studies (Grodzin and Balk, 1997;Clementsen et al, 1998;Putnam et al, 2000;Parulekar et al, 2001) and the British Thoracic Society (BTS) guidelines for the management of malignant pleural effusions (Antunes et al, 2003) recommend the use of small-caliber catheters in lieu of larger-caliber chest tubes.…”

Section: Introductionmentioning

confidence: 94%

Management of traumatic hemothorax by closed thoracic drainage using a central venous catheter

Liu

Zhang

et al. 2012

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To evaluate the efficacy and safety of the treatment of traumatic hemothorax by closed pleural drainage using a central venous catheter (CVC), compared with using a conventional chest tube. Methods: A prospective controlled study with the Ethics Committee approval was undertaken. A total of 407 patients with traumatic hemothorax were involved and they were randomly assigned to undergo closed pleural drainage with CVCs (n=214) or conventional chest tubes (n=193). The Seldinger technique was used for drainage by CVC, and the conventional technique for drainage by chest tube. If the residual volume of the hemothorax was less than 200 ml after the daily volume of drainage decreased to below 100 ml for two consecutive days, the treatment was considered successful. The correlative data of efficacy and safety between the two groups were analyzed using t or chi-squared tests with SPSS 13.0. A P value of less than 0.05 was taken as indicating statistical significance. Results: Compared with the chest tube group, the operation time, fraction of analgesic treatment, time of surgical wound healing, and infection rate of surgical wounds were significantly decreased (P<0.05) in the CVC group. There were no significant differences between the two groups in the success rate of treatment and the incidence of serious complications (P>0.05), or in the mean catheter/tube indwelling time and mean medical costs of patients treated successfully (P>0.05). Conclusions: Management of medium or large traumatic hemothoraxes by closed thoracic drainage using CVC is minimally invasive and as effective as using a conventional large-bore chest tube. Its complications can be prevented and it has the potential to replace the large-bore chest tube.

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Indwelling Small Pleural Catheter Needle Thoracentesis in the Management of Large Pleural Effusions

Cited by 57 publications

References 5 publications

Pigtail Catheter Use for Draining Pleural Effusions of Various Etiologies

Pigtail Catheter Use for Draining Pleural Effusions of Various Etiologies

Outpatient Management of Malignant Pleural Effusions with Small-Bore, Tunneled Pleural Catheters

Management of traumatic hemothorax by closed thoracic drainage using a central venous catheter

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