Intensive care unit

Chest tube

Percutaneous

Interquartile range

Surgery

Psychiatry

Anesthesia

Emergency department

Cardiothoracic surgery

Pneumothorax

Internal medicine

Cardiac surgery

Medicine

Hemopneumothorax

Randomized controlled trial

World Journal of Surgery

Introduction Traditional management of traumatic hemothorax/hemopneumothorax (HTX/HPTX) has been insertion of large‐bore 32–40 French (Fr) chest tubes (CTs). Retrospective studies have shown 14Fr percutaneous pigtail catheters (PCs) are equally effective as CTs. Our aim was to compare effectiveness between PCs and CTs by performing the first randomized controlled trial (RCT). We hypothesize PCs work equally as well as CTs in management of traumatic HTX/HPTX. Methods Prospective RCT comparing 14Fr PCs to 28–32Fr CTs for management of traumatic HTX/HPTX from 07/2015 to 01/2018. We excluded patients requiring emergency tube placement or who refused. Primary outcome was failure rate defined as retained HTX or recurrent PTX requiring additional intervention. Secondary outcomes included initial output (IO), tube days and insertion perception experience (IPE) score on a scale of 1–5 (1 = tolerable experience, 5 = worst experience). Unpaired Student's t ‐test, chi‐square and Wilcoxon rank‐sum test were utilized with significance set at P &lt; 0.05. Results Forty‐three patients were enrolled. Baseline characteristics between PC patients ( N = 20) and CT patients ( N = 23) were similar. Failure rates (10% PCs vs. 17% CTs, P = 0.49) between cohorts were similar. IO (median, 650 milliliters[ml]; interquartile range[IR], 375–1087; for PCs vs. 400 ml; IR, 240–700; for CTs, P = 0.06), and tube duration was similar, but PC patients reported lower IPE scores (median, 1, “I can tolerate it”; IR, 1–2) than CT patients (median, 3, “It was a bad experience”; IR, 3–4, P = 0.001). Conclusion In patients with traumatic HTX/HPTX, 14Fr PCs were equally as effective as 28–32Fr CTs with no significant difference in failure rates. PC patients, however, reported a better insertion experience. www.ClinicalTrials.gov Registration ID: NCT02553434

Randomized Clinical Trial of 14‐French (14F) Pigtail Catheters <i>versus</i> 28–32F Chest Tubes in the Management of Patients with Traumatic Hemothorax and Hemopneumothorax

Randomized Clinical Trial of 14‐French (14F) Pigtail Catheters versus 28–32F Chest Tubes in the Management of Patients with Traumatic Hemothorax and Hemopneumothorax