Small Caliber Catheter Drainage for Spontaneous Pneumothorax

Matsuda, Hiroyuki; Saka, Hideki; Senda, Kazuyoshi; Horio, Yuko; Iwahara, T.; Nomura, Fumio; Sakai, Shuzo; Shimokata, Keiko

doi:10.1097/00000441-199212000-00002

Cited by 68 publications

(42 citation statements)

References 8 publications

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“…Subsequent studies included first episodes and recurrences of PSP, as well as secondary, traumatic and iatrogenic PTX [16][17][18][19][20][21]. Except for one study [16], the catheters were catheter-over-needle systems, with no shielding of the needle tip, and were placed either with [13][14][15]23] or without [16][17][18][19][20][21][22]24] radiological or ultrasound guidance. Not surprisingly, suction applied to these small catheters functioned as well as simple MA.…”

Section: Discussionmentioning

confidence: 99%

“…When suction failed to give immediate re-expansion, connection to a one-way valve was advised, eventually followed by wall suction if the air leak continued. The failure rate of catheter wall suction when MA had failed ranged from 8-31% [16,[18][19][20][21]. Most of these studies were retrospective and therefore did not follow clear recommendations regarding the stepwise management of underlying air leaks.…”

Section: Discussionmentioning

confidence: 99%

“…Such small catheters have proved successful in mixed pneumothorax (PTX) populations, most of them being iatrogenic [13][14][15][16][17][18][19][20][21][22][23][24]. The purpose of the present study was to assess the feasibility, safety and effectiveness of a comprehensive therapeutic algorithm that used small-calibre catheters connected to a one-way valve in first episodes of PSP.…”

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confidence: 99%

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Simplified stepwise management of primary spontaneous pneumothorax: a pilot study

Ch¹

2006

European Respiratory Journal

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In primary spontaneous pneumothorax (PSP) requiring intervention, removal of air from the pleural space can be achieved by manual needle aspiration or by pleural drainage after insertion of a chest tube. This study aimed to evaluate the efficacy and safety of a serial-steps approach with a single system (small-calibre catheter/Heimlich valve) in a homogeneous population of patients with a first episode of PSP.All patients had an 8.5 F distally multiperforated polyurethane pigtail catheter inserted via the anterior route, at the bedside without any guidance, using the Seldinger technique. A one-way Heimlich valve was connected to the catheter, allowing the air to flow spontaneously outwards for 24-48 h. Thereafter, if the lung failed to re-expand wall suction was applied. Patients with an air leak persisting for .4 days were referred for surgery. Primary end-points were success rates at 24 h and 1 week, and 1 yr recurrence-free survival.In total, 41 consecutive patients entered the study. They were typically thin, young, smoking males. No procedure-related complications were observed. The need for pain relief medication was minimal. Within the first 24 h, most of the patients were able to walk around and half of them were able to take a shower with their catheter in place. The 24-h and 1-week success rates were 61 and 85%, respectively, and the actuarial 1-yr recurrence rate was 24%. Four patients underwent surgical pleurodesis because of a persistent air leak. The length of stay when excluding the four surgical cases was 2.3¡1.3 days.When 24-h and 1-week success rates and recurrence at 12 months were taken as end-points, the method described here is as effective as simple manual needle aspiration or a conventional chest tube thoracotomy. These results support further studies assessing this ''one system, serialsteps approach'' in an outpatient management algorithm.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Simplified stepwise management of primary spontaneous pneumothorax: a pilot study

Ch¹

2006

European Respiratory Journal

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“…19 Ninety-five percent of pneumothoraces are successfully treated at first attendance with observation alone or with a short period of intercostal tube drainage. 20 Other methods of chest tube drainage that are safe, simple and effective are mini-thoracostomy tubes, 21 small catheter drainage 22 or the Heimlich flutter valve. 23,24 There were three patients (12%) among our 25 patients with, recurrence of SP.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Pneumothorax: A Retrospective Study of Twenty-Five Patients and Literature Review

et al. 1996

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We present a retrospective study of 25 patients with spontaneous pneumothorax (three recurrent), comprising 16 Saudis (nine males and seven females) and nine non-Saudis (eight males and one female), seen at the Asir Central Hospital, Abha, over a period of 45 months. Almost one-third of the patients (9/25) had no underlying cause discernible by our investigational facilities (chest x-ray, ultrasonography, computed tomographic scan, and flexible bronchofiberscopy). Underlying pneumonia (three patients), pulmonary tuberculosis (two patients), lung abscess (one patient), and congenital bullae (one patient) constituted the etiology in another third of the spontaneous pneumothorax patients. Other underlying pulmonary diseases precipitating spontaneous pneumothorax in the group included pulmonary fibrosis, metastatic mesothelioma, and immunosuppression in a medulloblastoma patient undergoing chemotherapy with the development of chickenpox. Closed thoracostomy tube drainage was the only method of treatment in 20 out of the 25 patients, with three failures of closed thoracostomy tube drainage needing thoracotomy and resection of blebs/bullae. The only complication was empyema in two of the patients. Two patients were successfully treated conservatively with observation alone. Ann Saudi Med 1996;16(3):249-253. A-N Batouk, S Jastaniah, IA Grillo, TS Malatani, AH Al-Saigh, MY Al-Shehri, B Teklu, A Softah, KA Mohmed Ali, Spontaneous Pneumothorax: a Retrospective Study of Twenty-Five Patients and Literature Review. 1996; 16(3): 249-253 The term pneumothorax was introduced almost two centuries ago by Itard in 1803, and popularized by Laennec in 1819.1 From that time until the mid-1930s, it was thought that all pneumothoraces were secondary to pulmonary tuberculosis.2 Kjaergaard's review of the subject in 1932 highlighted the occurrence of the condition in previously healthy individuals.3 If these "healthy individuals" had been thoroughly studied with modern medical, radiological or endoscopic investigations, they might have been found to have such occult abnormalities as blebs, bullae, or bronchial obstructions. 4 The Asir region of Saudi Arabia is a mountainous territory of about one million people, served by the Asir Central Hospital (ACH), a 450-bed tertiary hospital. Over a period of three years and nine months (1990)(1991)(1992)(1993)(1994), 25 patients were treated for spontaneous pneumothorax (SP) at ACH. As this problem has not been previously reviewed in this part of the world, we are presenting the first 25 adult patients of SP seen in this region and reviewing the literature in light of our experience. Patients and MethodsTwenty-five patients with spontaneous pneumothorax (SP) constitute the subjects of this retrospective study (April .1990 to December 1994. The patients consisted of 16 Saudis and nine non-Saudis seen at ACH, either on direct admission through the Emergency Department or upon referral from neighboring hospitals and admitted or evaluated only as outpatients. The demographics (nationality, sex...

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“…They are attached variously to three-way taps and syringes for simple aspiration, flutter valves, Heimlich valves or underwater seal systems [16][17][18]. These techniques have minimal morbidity, allow early discharge of a significant minority of patients and may enable the continuation of therapy through a sequential approach, albeit at a slightly higher financial cost than ''simple'' aspiration.…”

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confidence: 99%

Simple sequential treatment for primary spontaneous pneumothorax: one step closer

Mt¹

2006

European Respiratory Journal

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Small Caliber Catheter Drainage for Spontaneous Pneumothorax

Cited by 68 publications

References 8 publications

Simplified stepwise management of primary spontaneous pneumothorax: a pilot study

Simplified stepwise management of primary spontaneous pneumothorax: a pilot study

Spontaneous Pneumothorax: A Retrospective Study of Twenty-Five Patients and Literature Review

Simple sequential treatment for primary spontaneous pneumothorax: one step closer

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