Ultrasound-guided pigtail catheters for drainage of various pleural diseases.
OBJECTIVE
Little is known about the efficacy and safety of ultrasound-guided pigtail catheters for the management of various pleural diseases in the emergency department, ward, and intensive care unit.


METHODS
We conducted a retrospective study in a university hospital during a 1-year interval.


RESULTS
A total of 276 patients (178 men and 98 women) underwent 332 pigtail catheters (the drain size ranged from 10F to 16F) under ultrasound guidance. The mean ± SEM patient age was 59 ± 18 years, and mean duration of drainage was 6.1 ± 2 days. A total of 64 drains (19.2%) were inserted for pneumothoraces; 98 drains (29.5%), for malignant effusions; 119 drains (35.8%), for parapneumonic effusions/empyemas; and 38 drains (11.4%), for massive transudate pleural effusions. The overall success rate was 72.9%. The success rate was highest when the drain was used to treat massive transudate effusions (81.6%) and malignant pleural effusions (75.5%), followed by parapneumonic effusions/empyemas (72.2%), hemothoraces (66.6%), and pneumothoraces (64.0%). Only 10 (3.0%) drains had complications due to the procedure, including infection (n = 4, 1.2%), dislodgment (n = 4, 1.2%), wound bleeding at the pigtail catheter puncture area complicated with hemothoraces (n = 1, 0.3%), and lung puncture (n = 1, 0.3%). There was no significant difference in success rate when different catheter sizes were used to treat pleural diseases.


CONCLUSIONS
Ultrasound-guided pigtail catheters provide a safe and effective method of draining various pleural diseases. We strongly suggest that ultrasound-guided pigtail catheters be considered as the initial draining method for a variety of pleural diseases.
Liu
Yi-Heng
YH
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan.
Lin
Yu-Chao
YC
Liang
Shinn-Jye
SJ
Tu
Chih-Yen
CY
Chen
Chia-Hung
CH
Chen
Hung-Jen
HJ
Chen
Wei
W
Shih
Chuen-Ming
CM
Hsu
Wu-Huei
WH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation*; D016724:Empyema, Pleural / Q000628:therapy; D005260:Female; D006491:Hemothorax / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000628:therapy*; D010996:Pleural Effusion / Q000628:therapy; D016066:Pleural Effusion, Malignant / Q000628:therapy; D011030:Pneumothorax / Q000628:therapy; D012189:Retrospective Studies; D014463:Ultrasonography / Q000295:instrumentation; D055815:Young Adult