title: Pigtail catheter for the management of pneumothorax in mechanically ventilated patients.
abstract: OBJECTIVE
  There has been a paucity of data regarding the efficacy and safety of small-bore chest tubes (pigtail catheter) for the management of pneumothorax in mechanically ventilated patients.
  
  
  METHODS
  We conducted a retrospective review of mechanically ventilated patients who underwent pigtail catheter drainage as their initial therapy for pneumothorax in the emergency department and intensive care unit from January 2004 through January 2007 in a university hospital.
  
  
  RESULTS
  Among the 62 enrolled patients, there were 41 men (66%) and 21 women (34%), with a mean age of 63.8 +/- 20.3 years. A total of 70 episodes of pneumothoraces occurred in the intensive care unit, and 48 episodes of pneumothoraces (68.6%) were successfully treated with pigtail catheters. The average duration of pigtail drainage was 5.9 days (1-27 days). No major complications occurred through use of this procedure, except for pleural infections (n = 3, 4.2%) and clogged tube (n = 1, 1.4%). Comparing the variables between the success and failure of pigtail treatment, the failure group had a significantly higher proportion of Fio(2) >60% requirement (45.5% vs. 14.6%, P = .005) and higher positive end-expiratory pressure levels (8.7 +/- 3.0 vs. 6.2+/- 2.3 mm Hg, P = .001) at the time of pneumothorax onset than the success group. Further comparing the efficacy of pigtail drainage between barotraumas and iatrogenic pneumothorax, pigtail catheters for management of iatrogenic pneumothorax had a significantly higher success rate than barotraumas (87.5% vs. 43.3%, P < .0001).
  
  
  CONCLUSIONS
  Pigtail catheter drainage is relatively effective in treating iatrogenic but less promising for barotraumatic pneumothoraces.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Yu-Chao
authors.initials: YC
authors.lastname: Lin
authors.forename: Chih-Yen
authors.initials: CY
authors.lastname: Tu
authors.forename: Shinn-Jye
authors.initials: SJ
authors.lastname: Liang
authors.forename: Hung-Jen
authors.initials: HJ
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Te-Chun
authors.initials: TC
authors.lastname: Hsia
authors.forename: Chuen-Ming
authors.initials: CM
authors.lastname: Shih
authors.forename: Wu-Huei
authors.initials: WH
authors.lastname: Hsu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015505:Chest Tubes / Q000009:adverse effects; D004322:Drainage / Q000379:methods; D004636:Emergency Service, Hospital; D004868:Equipment Failure; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011175:Positive-Pressure Respiration; D012121:Respiration, Artificial; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult