Abstract
Beside standard chest tube drainage other less invasive techniques have been used in the management of patients with an acute episode of spontaneous pneumothorax. The aim of the study was to evaluate the short term effect of spontaneous pneumothorax treatment with small-bore pleural catheter and manual aspiration as compared to large-bore chest tube drainage. Patients with an episode of pneumothorax who required pleural intervention were enrolled in the study and randomly assigned to one of the treatment arms: (1) small-bore pleural catheter (8 Fr) with manual aspiration; (2) standard chest tube drainage (20–24 Fr). Success rate of the first line treatment, duration of catheter or chest tube drainage, and the need for surgical intervention were the outcome measures. The study group included 49 patients (mean age 46.9 ± 21.3 years); with 22 and 27 allocated to small bore manual aspiration and chest tube drainage groups, respectively. There were no significant differences in the baseline characteristics of patients in both therapeutic arms. First line treatment success rates were 64 % and 82 % in the manual aspiration and chest tube drainage groups, respectively; the difference was insignificant. Median time of treatment with small bore catheter was significantly shorter than conventional chest tube drainage (2.0 vs. 6.0 days; p < 0.05). Our results show that treatment of spontaneous pneumothorax with small-bore pleural catheter and manual aspiration might be similarly effective as is chest tube drainage in terms of immediate lung re-expansion.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Ayed AK, Chandrasekaran C, Sukumar M (2006) Aspiration versus tube drainage in primary spontaneous pneumothorax: a randomised study. Eur Respir J 27:477–482
Baumann M, Strange C, Heffner J, Light R, Kirby T, Klein J, Luketich J, Panacek E, Sahn S (2001) Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest 119:590–602
Benton I, Benfield G (2009) Comparison of a large and small-calibre tube drain for managing spontaneous pneumothoraces. Respir Med 103:1436–1440
Chambers A, Scarci M (2009) In patients with first-episode primary spontaneous pneumothorax is video-assisted thoracoscopic surgery superior to tube thoracostomy alone in terms of time to resolution of pneumothorax and incidence of recurrence? Interact Cardiovasc Thorac Surg 9:1003–1008
Cho S, Lee E (2010) Management of primary and secondary pneumothorax using a small-bore thoracic catheter. Interact Cardiovasc Thorac Surg 11:146–149
Contou D, Razazi K, Katsahian S, Maitre B, Mekontso-Dessap A, Brun-Buisson C, Thille A (2012) Small-bore catheter versus chest tube drainage for pneumothorax. Am J Emerg Med 30:1407–1413
Devanand A, Koh M, Ong T, Low S, Phua G, Tan K, Philip E, Samuel M (2004) Simple aspiration versus chest-tube insertion in the management of primary spontaneous pneumothorax: a systematic review. Respir Med 98:579–590
Gupta D, Hansell A, Nichols T, Duong T, Ayres JG, Strachan D (2000) Epidemiology of pneumothorax in England. Thorax 55:666–671
Harvey J, Prescott RJ (1994) Simple aspiration versus intercostal tube drainage for spontaneous pneumothorax in patients with normal lungs. British Thoracic Society Research Committee. Br Med J 309:1338–1339
Henry M, Arnold T, Harvey J (2003) BTS guidelines for the management of spontaneous pneumothorax. Thorax 58(Suppl 2):ii39–ii52
Ho KK, Ong MEH, Koh MS, Wong E, Raghuram J (2011) A randomized controlled trial comparing minichest tube and needle aspiration in outpatient management of primary spontaneous pneumothorax. Am J Emerg Med 29:1152–1157
Huang Y, Huang H, Li Q, Browning RF, Parrish S, Turner JF, Zarogoulidis K, Kougioumtzi I, Dryllis G, Kioumis I, Pitsiou G, Machairiotis N, Katsikogiannis N, Courcoutsakis N, Madesis A, Diplaris K, Karaiskos T, Zarogoulidis P (2014) Approach of the treatment for pneumothorax. J Thorac Dis 6:S416–S420
Kuo H, Lin Y, Huang C, Chien S, Lin I, Lo M, Liang C (2013) Small-bore pigtail catheters for the treatment of primary spontaneous pneumothorax in young adolescents. Emerg Med J 30:e17
Lai S, Tee A (2012) Outpatient treatment of primary spontaneous pneumothorax using a small-bore chest drain with a Heimlich valve: the experience of a Singapore emergency department. Eur J Emerg Med 19:400–404
MacDuff A, Arnold A, Harvey J (2010) Management of spontaneous pneumothorax. British Thoracic Society pleural disease guideline 2010. Thorax 65:Ii18–Ii31
Noppen M, De Keukeleire T (2008) Pneumothorax. Respiration 76:121–127
Noppen M, Alexander P, Driesen P, Slabbynck H, Verstraeten A (2002) Manual aspiration versus chest tube drainage in first episodes of primary spontaneous pneumothorax: a multicenter, prospective, randomized pilot study. Am J Respir Crit Care Med 165:1240–1244
Parlak M, Uil SM, van den Berg JWK (2012) A prospective, randomised trial of pneumothorax therapy: manual aspiration versus conventional chest tube drainage. Respir Med 106:1600–1605
Schramel FM, Postmus PE, Vanderschueren RG (1997) Current aspects of spontaneous pneumothorax. Eur Respir J 10:1372–1379
Zehtabchi S, Rios CL (2008) Management of emergency department patients with primary spontaneous pneumothorax: needle aspiration or tube thoracostomy? Ann Emerg Med 51:91–100
Conflicts of Interest
The authors declare no conflicts of interest in relation to this article.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Korczyński, P., Górska, K., Nasiłowski, J., Chazan, R., Krenke, R. (2015). Comparison of Small Bore Catheter Aspiration and Chest Tube Drainage in the Management of Spontaneous Pneumothorax. In: Pokorski, M. (eds) Noncommunicable Diseases. Advances in Experimental Medicine and Biology(), vol 866. Springer, Cham. https://doi.org/10.1007/5584_2015_146
Download citation
DOI: https://doi.org/10.1007/5584_2015_146
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-19973-3
Online ISBN: 978-3-319-19974-0
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)