A pilot study of chest tube versus pigtail catheter drainage of acute hemothorax in swine

Rachel M. Russo, Scott A. Zakaluzny, Lucas P. Neff, J. Kevin Grayson, Rachel A. Hight, Joseph M Galante, David V Shatz

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND Evacuation of traumatic hemothorax (HTx) is typically accomplished with large-bore (28-40 Fr) chest tubes, often resulting in patient discomfort. Management of HTx with smaller (14 Fr) pigtail catheters has not been widely adopted because of concerns about tube occlusion and blood evacuation rates. We compared pigtail catheters with chest tubes for the drainage of acute HTx in a swine model. METHODS Six Yorkshire cross-bred swine (44-54 kg) were anesthetized, instrumented, and mechanically ventilated. A 32 Fr chest tube was placed in one randomly assigned hemithorax; a 14 Fr pigtail catheter was placed in the other. Each was connected to a chest drainage system at-20 cm H2O suction and clamped. Over 15 minutes, 1,500 mL of arterial blood was withdrawn via femoral artery catheters. Seven hundred fifty milliliters of the withdrawn blood was instilled into each pleural space, and fluid resuscitation with colloid was initiated. The chest drains were then unclamped. Output from each drain was measured every minute for 5 minutes and then every 5 minutes for 40 minutes. The swine were euthanized, and thoracotomies were performed to quantify the volume of blood remaining in each pleural space and to examine the position of each tube. RESULTS Blood drainage was more rapid from the chest tube during the first 3 minutes compared with the pigtail catheter (348 ± 109 mL/min vs. 176 ± 53 mL/min), but this difference was not statistically significant (p = 0.19). Thereafter, the rates of drainage between the two tubes were not substantially different. The chest tube drained a higher total percentage of the blood from the chest (87.3% vs. 70.3%), but this difference did not reach statistical significance (p = 0.21). CONCLUSION We found no statistically significant difference in the volume of blood drained by a 14 Fr pigtail catheter compared with a 32 Fr chest tube.

Original languageEnglish (US)
Pages (from-to)1038-1043
Number of pages6
JournalJournal of Trauma and Acute Care Surgery
Volume79
Issue number6
DOIs
StatePublished - Dec 1 2015

Fingerprint

Hemothorax
Chest Tubes
Drainage
Swine
Catheters
Thorax
Blood Volume
Suction
Colloids
Thoracotomy
Femoral Artery
Resuscitation

Keywords

  • drainage
  • hemothorax
  • pigtail catheter
  • Swine
  • trauma

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

Cite this

A pilot study of chest tube versus pigtail catheter drainage of acute hemothorax in swine. / Russo, Rachel M.; Zakaluzny, Scott A.; Neff, Lucas P.; Grayson, J. Kevin; Hight, Rachel A.; Galante, Joseph M; Shatz, David V.

In: Journal of Trauma and Acute Care Surgery, Vol. 79, No. 6, 01.12.2015, p. 1038-1043.

Research output: Contribution to journalArticle

Russo, Rachel M. ; Zakaluzny, Scott A. ; Neff, Lucas P. ; Grayson, J. Kevin ; Hight, Rachel A. ; Galante, Joseph M ; Shatz, David V. / A pilot study of chest tube versus pigtail catheter drainage of acute hemothorax in swine. In: Journal of Trauma and Acute Care Surgery. 2015 ; Vol. 79, No. 6. pp. 1038-1043.
@article{3c33124c8ca64caeb7dab9325b3aa096,
title = "A pilot study of chest tube versus pigtail catheter drainage of acute hemothorax in swine",
abstract = "BACKGROUND Evacuation of traumatic hemothorax (HTx) is typically accomplished with large-bore (28-40 Fr) chest tubes, often resulting in patient discomfort. Management of HTx with smaller (14 Fr) pigtail catheters has not been widely adopted because of concerns about tube occlusion and blood evacuation rates. We compared pigtail catheters with chest tubes for the drainage of acute HTx in a swine model. METHODS Six Yorkshire cross-bred swine (44-54 kg) were anesthetized, instrumented, and mechanically ventilated. A 32 Fr chest tube was placed in one randomly assigned hemithorax; a 14 Fr pigtail catheter was placed in the other. Each was connected to a chest drainage system at-20 cm H2O suction and clamped. Over 15 minutes, 1,500 mL of arterial blood was withdrawn via femoral artery catheters. Seven hundred fifty milliliters of the withdrawn blood was instilled into each pleural space, and fluid resuscitation with colloid was initiated. The chest drains were then unclamped. Output from each drain was measured every minute for 5 minutes and then every 5 minutes for 40 minutes. The swine were euthanized, and thoracotomies were performed to quantify the volume of blood remaining in each pleural space and to examine the position of each tube. RESULTS Blood drainage was more rapid from the chest tube during the first 3 minutes compared with the pigtail catheter (348 ± 109 mL/min vs. 176 ± 53 mL/min), but this difference was not statistically significant (p = 0.19). Thereafter, the rates of drainage between the two tubes were not substantially different. The chest tube drained a higher total percentage of the blood from the chest (87.3{\%} vs. 70.3{\%}), but this difference did not reach statistical significance (p = 0.21). CONCLUSION We found no statistically significant difference in the volume of blood drained by a 14 Fr pigtail catheter compared with a 32 Fr chest tube.",
keywords = "drainage, hemothorax, pigtail catheter, Swine, trauma",
author = "Russo, {Rachel M.} and Zakaluzny, {Scott A.} and Neff, {Lucas P.} and Grayson, {J. Kevin} and Hight, {Rachel A.} and Galante, {Joseph M} and Shatz, {David V}",
year = "2015",
month = "12",
day = "1",
doi = "10.1097/TA.0000000000000693",
language = "English (US)",
volume = "79",
pages = "1038--1043",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - A pilot study of chest tube versus pigtail catheter drainage of acute hemothorax in swine

AU - Russo, Rachel M.

AU - Zakaluzny, Scott A.

AU - Neff, Lucas P.

AU - Grayson, J. Kevin

AU - Hight, Rachel A.

AU - Galante, Joseph M

AU - Shatz, David V

PY - 2015/12/1

Y1 - 2015/12/1

N2 - BACKGROUND Evacuation of traumatic hemothorax (HTx) is typically accomplished with large-bore (28-40 Fr) chest tubes, often resulting in patient discomfort. Management of HTx with smaller (14 Fr) pigtail catheters has not been widely adopted because of concerns about tube occlusion and blood evacuation rates. We compared pigtail catheters with chest tubes for the drainage of acute HTx in a swine model. METHODS Six Yorkshire cross-bred swine (44-54 kg) were anesthetized, instrumented, and mechanically ventilated. A 32 Fr chest tube was placed in one randomly assigned hemithorax; a 14 Fr pigtail catheter was placed in the other. Each was connected to a chest drainage system at-20 cm H2O suction and clamped. Over 15 minutes, 1,500 mL of arterial blood was withdrawn via femoral artery catheters. Seven hundred fifty milliliters of the withdrawn blood was instilled into each pleural space, and fluid resuscitation with colloid was initiated. The chest drains were then unclamped. Output from each drain was measured every minute for 5 minutes and then every 5 minutes for 40 minutes. The swine were euthanized, and thoracotomies were performed to quantify the volume of blood remaining in each pleural space and to examine the position of each tube. RESULTS Blood drainage was more rapid from the chest tube during the first 3 minutes compared with the pigtail catheter (348 ± 109 mL/min vs. 176 ± 53 mL/min), but this difference was not statistically significant (p = 0.19). Thereafter, the rates of drainage between the two tubes were not substantially different. The chest tube drained a higher total percentage of the blood from the chest (87.3% vs. 70.3%), but this difference did not reach statistical significance (p = 0.21). CONCLUSION We found no statistically significant difference in the volume of blood drained by a 14 Fr pigtail catheter compared with a 32 Fr chest tube.

AB - BACKGROUND Evacuation of traumatic hemothorax (HTx) is typically accomplished with large-bore (28-40 Fr) chest tubes, often resulting in patient discomfort. Management of HTx with smaller (14 Fr) pigtail catheters has not been widely adopted because of concerns about tube occlusion and blood evacuation rates. We compared pigtail catheters with chest tubes for the drainage of acute HTx in a swine model. METHODS Six Yorkshire cross-bred swine (44-54 kg) were anesthetized, instrumented, and mechanically ventilated. A 32 Fr chest tube was placed in one randomly assigned hemithorax; a 14 Fr pigtail catheter was placed in the other. Each was connected to a chest drainage system at-20 cm H2O suction and clamped. Over 15 minutes, 1,500 mL of arterial blood was withdrawn via femoral artery catheters. Seven hundred fifty milliliters of the withdrawn blood was instilled into each pleural space, and fluid resuscitation with colloid was initiated. The chest drains were then unclamped. Output from each drain was measured every minute for 5 minutes and then every 5 minutes for 40 minutes. The swine were euthanized, and thoracotomies were performed to quantify the volume of blood remaining in each pleural space and to examine the position of each tube. RESULTS Blood drainage was more rapid from the chest tube during the first 3 minutes compared with the pigtail catheter (348 ± 109 mL/min vs. 176 ± 53 mL/min), but this difference was not statistically significant (p = 0.19). Thereafter, the rates of drainage between the two tubes were not substantially different. The chest tube drained a higher total percentage of the blood from the chest (87.3% vs. 70.3%), but this difference did not reach statistical significance (p = 0.21). CONCLUSION We found no statistically significant difference in the volume of blood drained by a 14 Fr pigtail catheter compared with a 32 Fr chest tube.

KW - drainage

KW - hemothorax

KW - pigtail catheter

KW - Swine

KW - trauma

UR - http://www.scopus.com/inward/record.url?scp=84949024402&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84949024402&partnerID=8YFLogxK

U2 - 10.1097/TA.0000000000000693

DO - 10.1097/TA.0000000000000693

M3 - Article

C2 - 26317812

AN - SCOPUS:84949024402

VL - 79

SP - 1038

EP - 1043

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 6

ER -