Eur J Pediatr Surg 2013; 23(05): 389-393
DOI: 10.1055/s-0033-1333641
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Transitioning from Stiff Chest Tubes to Soft Pleural Catheters: Prospective Assessment of a Practice Change

Kathryn Martin
1   Division of Pediatric General and Thoracic Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
,
Sherif Emil
1   Division of Pediatric General and Thoracic Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
,
Samara Zavalkoff
2   Division of Pediatric Critical Care, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
,
Andrea Lo
1   Division of Pediatric General and Thoracic Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
,
Michael Ganey
1   Division of Pediatric General and Thoracic Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
,
Robert Baird
1   Division of Pediatric General and Thoracic Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
,
Josee Gaudreault
2   Division of Pediatric Critical Care, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
,
Romain Mandel
3   Division of Neonatal Intensive Care, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
,
Thérèse Perreault
3   Division of Neonatal Intensive Care, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
,
Andréane Pharand
3   Division of Neonatal Intensive Care, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
› Institutsangaben
Weitere Informationen

Publikationsverlauf

28. August 2012

08. Dezember 2012

Publikationsdatum:
26. Februar 2013 (online)

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Abstract

Background Tube thoracostomies in children are required for multiple indications and can be associated with significant discomfort. In 2010, a multidisciplinary team at our institution developed a protocol to replace stiff chest tubes with 8.5-French soft pleural catheters in children requiring pleural drainage.

Methods Before initiating the protocol, an audit sheet was developed to prospectively capture data regarding insertion, removal, complications, and success. After 8 months of new protocol utilization, these data were reviewed, along with a retrospective review of the patients' charts.

Results Twenty-three patients had 33 pleural catheters inserted over an 8-month period. Mean age was 6.7 years (1 day to 17 years). Indications for insertion were pneumothorax (24%), simple effusion (24%), chylothorax (27%), parapneumonic effusion/empyema (21%), and malignant effusion (3%). Complications included premature dislodgment (33%), blockage (15%), pneumothorax (3%), and bleeding (3%). Mean duration of pleural drainage was 7.27 days (0 to 37 days). Pleural drainage was successful in 91% of patients.

Conclusion Soft pleural catheters are an acceptable alternative to traditional stiff chest tubes in the pediatric population. Premature dislodgment was the most common problem. Prospective audits are extremely valuable in assessing new procedural protocols and practice changes.

Note

This article was presented at the 43rd annual meeting of the Canadian Association of Pediatric Surgeons, Ottawa, Ontario, Canada, September 22 to 24, 2011.