Q; 34 years old male with a history of HIV is recovering in ICU from a septic shock. Patient complained of acute right-sided chest pain after intensive spirometry (IS). Chest X-ray showed Right-sided pneumothorax (PTX). What is the advantage of using a small bore catheter over a large bore chest tube to relieve PTX?
A) Early resolution of PTX
B) Reduced pain at the insertion site
C) High success rate
D) Less insertion-related complications
Answer: B
One advantage of placing a small-bore air drainage catheter in an uncomplicated pneumothorax is the reduced pain at the insertion site. For this type of pneumothorax, placement via the anterior midclavicular approach is usually preferred.
Interestingly, at least in one study, the 'surgical technique' and small bore pigtail failed to show any added advantage besides reduced pain (choice B).
With an experienced hand, the success rate (choice C) and complications (choice D) should be the same. Resolution of PTX depends highly on underlying pathology instead of insertion technique (choice A)
#procedures
Reference:
Kulvatunyou N, Erickson L, Vijayasekaran A, et al. Randomized clinical trial of pigtail catheter versus chest tube in injured patients with uncomplicated traumatic pneumothorax. Br J Surg 2014; 101:17.
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