Treatment of pneumothorax in newborns: use of venous catheter versus chest tube.
BACKGROUND
The traditional treatment for pneumothorax is tube thoracostomy. Chest tube placement often involves complications, particularly in newborns. The aim of this study is to introduce the method of air drainage with venous catheter and to compare two different methods, chest tube placement and venous catheter insertion, in the treatment of pneumothorax in newborns.


METHODS
We treated 72 newborn patients with pneumothorax over a 4-year period in neonatal intensive care units at two different medical centers. We randomly divided the patients into two groups. In group I, we treated the patients with chest tube placement technique. We used 18-gauge venous catheter connected to an underwater system to drain air in group II patients. The duration of the procedure, the period of time that the chest tube or catheter was left in place, and the complications associated with the two different procedures were statistically compared.


RESULTS
The time required to perform the venous catheter procedure was significantly shorter than that for chest tube placement (P < 0.05). The duration of the device in place was also significantly shorter in group II than group I (P < 0.05). Only two minor complications were recorded in patients who underwent venous catheter placement, and this group's complication rate was significantly lower than the rate in the chest tube group (P < 0.05).


CONCLUSIONS
Insertion of a venous catheter is a safe alternative to chest tube placement as a method of draining air from newborn patients with pneumothorax. This is an easy and quick bedside procedure and is particularly useful for newborn patients that require immediate air drainage.
Arda
Irfan Serdar
IS
Department of Pediatric Surgery, Neonatology Unit, Baskent University Faculty of Medicine, 1 Fevzi Cakmak caddesi 10, sokak no: 45, 06490 Bahçelievler, Ankara, Turkey. serdara@baskent-ank.edu.tr
Gürakan
Berkan
B
Alíefendíoğlu
Didem
D
Tüzün
Meriç
M
D002404:Catheterization; D015505:Chest Tubes; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011030:Pneumothorax / Q000628:therapy*; D013396:Suction / Q000379:methods*; D016896:Treatment Outcome