Download PDF
CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2023; 07(03): 159-165
DOI: 10.1055/s-0043-1761629
Original Article

High-Vacuum Drainage System in Percutaneous Image-Guided Thoracocentesis for Complex Pleural Effusions

Jiawei Alexander Yap 
1   Department of Diagnostic Imaging, Tan Tock Seng Hospital, Novena, Singapore
,
Krishna Mohan Gummalla 
1   Department of Diagnostic Imaging, Tan Tock Seng Hospital, Novena, Singapore
,
Martin Weng Chin H'ng 
1   Department of Diagnostic Imaging, Tan Tock Seng Hospital, Novena, Singapore
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Purpose Our retrospective study is aimed to analyze the efficacy and outcomes between high-vacuum suction drain (HVSD) over passive drainage in the setting of percutaneous image-guided thoracocentesis, with a secondary aim to determine if preprocedural computed tomography (CT) can aid decision-making.

Methods Clinical and imaging details of patients using HVSD between November 2012 and October 2018, who had a preceding CT within a month before drainage, were collated. The control group was selected from patients who had thoracocentesis with passive drainage performed between November 2017 and October 2018. Cases where HVSD was the sole device were compared with those using only a chest bottle.

Results The HVSD was the only device in 17 cases compared to chest bottle in 47 cases. Mean duration being on a drain for these two arms were 5.5 and 7.3 days, respectively (p = 0.170). Fewer from the HVSD arm needed a repeat procedure (p = 0.424). Patients in the HVSD arm had significantly smaller volumes (p = 0.013) of higher density (p = 0.016), associated with a more encapsulating wall (p = 0.013) but not septations (p = 0.922). Density of contents on CT was useful in distinguishing between straw-colored effusion versus hemoserous fluid or pus (p = 0.008).

Conclusions HVSD was not inferior to the chest bottle in the setting of thoracocentesis. Considering its potential adjunctive benefits, it should be an option for draining smaller volume complex effusions. Due to poor correlation with preprocedural CT, decision to insert a HVSD should be made by the procedurist at the time of thoracentesis.

Keywords

complex pleural effusions - high-vacuum - thoracocentesis

Ethical Approval

Ethics approval was granted by the National Healthcare Group (NHG) Domain Specific Review Board.


Name and place of institution at which work was performed: Department of Diagnostic Imaging, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308 433.




Publication History

Article published online:
13 February 2023

© 2023. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Yu H. Management of pleural effusion, empyema, and lung abscess. Semin Intervent Radiol 2011; 28 (01) 75-86
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Shen KR, Bribriesco A, Crabtree T. et al. The American Association for Thoracic Surgery consensus guidelines for the management of empyema. J Thorac Cardiovasc Surg 2017; 153 (06) e129-e146
    CrossrefPubMedSearch in Google Scholar
  • 3 Deng B, Tan QY, Zhao YP, Wang RW, Jiang YG. Suction or non-suction to the underwater seal drains following pulmonary operation: meta-analysis of randomised controlled trials. Eur J Cardiothorac Surg 2010; 38 (02) 210-215
    CrossrefPubMedSearch in Google Scholar
  • 4 Newcomb AE, Alphonso N, Nørgaard MA, Cochrane AD, Karl TR, Brizard CP. High-vacuum drains rival conventional underwater-seal drains after pediatric heart surgery. Eur J Cardiothorac Surg 2005; 27 (03) 395-399
    CrossrefPubMedSearch in Google Scholar
  • 5 Feenstra TM, Dickhoff C, Deunk J. Systematic review and meta-analysis of tube thoracostomy following traumatic chest injury; suction versus water seal. Eur J Trauma Emerg Surg 2018; 44 (06) 819-827
    CrossrefPubMedSearch in Google Scholar
  • 6 Venuta F, Diso D, Anile M, Rendina EA, Onorati I. Chest tubes: generalities. Thorac Surg Clin 2017; 27 (01) 1-5
    CrossrefPubMedSearch in Google Scholar
  • 7 Savage SA, Cibulas II GA, Ward TA, Davis CA, Croce MA, Zarzaur BL. Suction evacuation of hemothorax: a prospective study. J Trauma Acute Care Surg 2016; 81 (01) 58-62
    CrossrefPubMedSearch in Google Scholar
  • 8 Kim H, Shyn PB, Wu L, Levesque VM, Khorasani R, Silverman SG. Wall suction-assisted image-guided thoracentesis: a safe alternative to evacuated bottles. Clin Radiol 2017; 72 (10) 898.e1-898.e5
    CrossrefPubMedSearch in Google Scholar
  • 9 Lang P, Manickavasagar M, Burdett C, Treasure T, Fiorentino F. UK Cardiothoracic Trainees' Research Collaborative, UK Cardiothoracic Trainees' Research Collaborative. Suction on chest drains following lung resection: evidence and practice are not aligned. Eur J Cardiothorac Surg 2016; 49 (02) 611-616
    CrossrefPubMedSearch in Google Scholar
  • 10 Abramowitz Y, Simanovsky N, Goldstein MS, Hiller N. Pleural effusion: characterization with CT attenuation values and CT appearance. AJR Am J Roentgenol 2009; 192 (03) 618-623
    CrossrefPubMedSearch in Google Scholar