Pigtail catheters versus traditional chest tubes for pneumothoraces in premature infants treated in a neonatal intensive care unit

Yi-Hsuan Wei; Cheng-Han Lee; Hsiao-Neng Cheng; Lon-Ten Tsao; Chien-Chou Hsiao

doi:10.1016/j.pedneo.2014.01.002

Pigtail catheters versus traditional chest tubes for pneumothoraces in premature infants treated in a neonatal intensive care unit

Pediatr Neonatol. 2014 Oct;55(5):376-80. doi: 10.1016/j.pedneo.2014.01.002. Epub 2014 Mar 19.

Authors

Yi-Hsuan Wei¹, Cheng-Han Lee¹, Hsiao-Neng Cheng², Lon-Ten Tsao¹, Chien-Chou Hsiao³

Affiliations

¹ Division of Neonatology, Department of Pediatric, Changhua Christian Hospital, Changhua, Taiwan.
² Division of Neonatology, Department of Pediatric, Changhua Christian Hospital, Changhua, Taiwan; Medical College of Chung Shan Medical University, Taichung, Taiwan.
³ Division of Neonatology, Department of Pediatric, Changhua Christian Hospital, Changhua, Taiwan; Medical College of Chung Shan Medical University, Taichung, Taiwan. Electronic address: 68206@cch.org.tw.

PMID: 24657110
DOI: 10.1016/j.pedneo.2014.01.002

Abstract

Background: Pneumothorax is more frequent in the neonatal period, especially among premature infants. Pigtail catheters have been shown to be as effective as and less invasive than traditional chest tubes in adults; however, data regarding premature infants are limited. We aimed to compare the efficacy, safety, and complications associated with the placement of traditional chest tubes versus pigtail catheters in premature infants with pneumothoraces.

Methods: We retrospectively reviewed the medical records of premature infants with pneumothorax seen in the neonatal intensive care unit of a single medical center over a period of 11 years, who were treated with either traditional chest tubes or pigtail catheters. Changes in the vital signs before and after the procedures were recorded in both groups. Data on age, sex, clinical presentation, procedure time, subsequent therapies, hospital days to discharge, success rate, and complications of the procedures were collected from medical records and compared between the two methods of intervention.

Results: Eighty-six thoracostomies, including 60 pigtail catheters and 26 traditional chest tubes, were performed in 66 premature infants. The success rate, demographics, days of tube insertion, length of hospital stay, days of mechanical ventilation, type of oxygen supply, and insertion-related complications were not significantly different between the two groups. Pigtail catheter insertion required a shorter procedure time than the traditional chest tube insertion (14.92 minutes vs. 25.31 minutes, respectively, p < 0.001).

Conclusion: Pigtail catheters are a safe and effective alternative to traditional chest tubes for premature infants receiving treatment for pneumothoraces in a neonatal intensive care unit. Placement of pigtail catheters is an easy and quick bedside procedure and is particularly useful for premature infants who require immediate air drainage.

Keywords: chest tube; pigtail catheter; pneumothorax; premature infant; thoracostomy.

MeSH terms

Catheters*
Chest Tubes*
Drainage / adverse effects
Drainage / instrumentation*
Drainage / methods
Equipment Design
Female
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / therapy*
Intensive Care Units, Neonatal
Length of Stay
Male
Pneumothorax / therapy*
Postoperative Complications
Respiration, Artificial
Retrospective Studies
Thoracostomy / adverse effects
Thoracostomy / instrumentation*
Thoracostomy / methods
Treatment Outcome