PT  - JOURNAL ARTICLE
AU  - Alexander Samokhvalov
AU  - Edward Altman
AU  - Amos Szabo
AU  - Tatiana Haj
AU  - Olga Rutsky
AU  - Nicola Makhoul
TI  - Aggressive treatment of simple pleural effusion in ventilated patients: Pigtail catheters versus thoracostomy
AID  - 10.1183/13993003.congress-2016.PA3576
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA3576
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA3576.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA3576.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - Introduction: Early and aggressive treatment of simple pleural effusion (SPE) in ventilated patients may improve their respiratory condition. Employment of ultrasonography and pigtail catheters for SPE management instead of standard methods has shown beneficial results, but is still under discussion.Aim of the study: To evaluate efficacy of ultrasonography and pigtail catheters for SPE management in ventilated patients versus chest x-ray, computed tomography (CT) and tube thoracostomy.Methods: Our retrospective study included 63 adult ICU ventilated patients with SPE from 01-2013 - 11-2015. In 32 patients (a-group) SPE was diagnosed and treated by ultrasonography and pigtail catheters. The other 31 patients (b-group) were managed by standard tube thoracostomy under chest x-ray/ CT . In every case pigtail catheters/ chest tubes were placed in costophrenic sinus.Results: Of 63 patients (42 males, 21 females; mean age 67.9; SD 14.52) the main causes of SPE were: congestive heart failure (29%), malignancy (24%) and pneumonia (19%). The median evacuated volume in the first 24 hours was 768.8ml (range 200-1900 ml). Drainage was continued for median 3.8 days (range 2-7.3 days). Ultrasonic navigation provided precise insertion of pigtail catheters. Thoracostomy tube position was correct in 72%. There were no complications in either group. Post-removal healing was uneventful with better cosmetic results in the a-group.Conclusions:1. Pigtail catheters had the same efficacy for evacuation of any SPE volume as standard tube thoracostomy.2 .Ultrasonography and pigtail catheters provided safe and more efficient management of SPE in ventilated patients than standard approach.