1887
Volume 2025, Issue 2
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

Pleural diseases are common and often require drainage, with the growing use of small-bore chest drains (SBCDs) instead of larger tubes. This review aimed to examine the failure rate and complications associated with SBCD use in different pleural pathologies.

A literature search (PubMed, SCOPUS, and Google Scholar) was performed on the complications associated with SBCDs to treat pleural diseases. This review analyzed patient demographics, indications, outcomes, failure rate, and complications associated with the use of SBCDs. The systematic review was conducted using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines.

Thirty studies were included in this review with 4,973 patients. The indications for insertions of SBCDs were pleural effusion at 48.4%, pneumothorax at 30.1%, empyema or parapneumonic effusion at 11.4%, hemothorax at 6.5%, and other indications at 3.6%. The overall failure rate to achieve satisfactory drainage was 19.4%. Significant complications included iatrogenic pneumothorax at 11.9%, major hemorrhage at 1.0%, local bleeding at 0.7%, infection at 1.2%, and iatrogenic organ injury at 0.9%. Other insertional complications included tube dislodgement at 5.9%, tube blockage at 5.4%, tube kinking at 3.7%, misplacement at 3.3%, and subcutaneous hematoma at 0.5%. Most of the data published revolves around hemodynamically stable patients with SBCD insertions and is, thus, deficient regarding hemodynamically unstable patients.

Despite carrying notable failure rates and complications, small-bore catheters remain an acceptable option for managing selected pleural diseases.

© 2025 Alomar, Tawfek, Alomar, Mahmood, Alomar, El-Menyar, et al., licensee HBKU Press.
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References

  1. Porcel JM. Chest tube drainage of the pleural space: a concise review for pulmonologists. Tuberc Respir Dis (Seoul). 2018; 81:(2)106–15. https://doi.org/10.4046/trd.2017.0107
     [Google الباحث العلمي]
  2. Gammie JS, Banks MC, Fuhrman CR, Pham SM, Griffith BP, Keenan RJ, et al.. The pigtail catheter for pleural drainage: a less invasive alternative to tube thoracostomy. JSLS. 1999; 3:(1)57–61.
    [Google الباحث العلمي]
  3. Elsayed A, Alkhalifa R, Alodayni M, Alanazi R, Alkhelaiwy L, Zalah M, et al.. Implication of pigtail catheter vs chest tube drainage. Int J Community Med Public Health. 2018; 5:3686.
    [Google الباحث العلمي]
  4. Fysh ET, Smith NA, Lee YCG. Optimal chest drain size: the rise of the small-bore pleural catheter. Semin Respir Crit Care Med. 2010; 31:(6)760–8.
    [Google الباحث العلمي]
  5. Schünemann HJ, Oxman AD, Brozek J, Glasziou P, Jaeschke R, Vist GE, et al.. Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ. 2008 336:(7653)110610. https://doi.org/10.1136/bmj.39500.677199.AE
    [Google الباحث العلمي]
  6. Davies HE, Merchant S, McGown A. A study of the complications of small bore ‘Seldinger’ intercostal chest drains. Respirology. 2008; 13:(4)603–7. https://doi.org/10.1111/j.1440-1843.2008.01296.x
     [Google الباحث العلمي]
  7. Vetrugno L, Guadagnin GM, Barbariol F, D’Incà S, Delrio S, Orso D, et al.. Assessment of pleural effusion and small pleural drain insertion by resident doctors in an intensive care unit: an observational study. Clin Med Insights Circ Respir Pulm Med. 2019; 13:1179548419871527. https://doi.org/10.1177/1179548419871527
     [Google الباحث العلمي]
  8. Congedo MT, Chiappetta M, Nachira D, Lococo F, Calabrese G, Tabacco D, et al.. Trocar vs. Seldinger small bore pleural drains: does the technique influence the outcomes?A prospective single-centre study. Eur Rev Med Pharmacol Sci. 2023; 27:(2)728–36. https://doi.org/10.26355/eurrev_202301_31075
     [Google الباحث العلمي]
  9. Kulvatunyou N, Vijayasekaran A, Hansen A, Wynne JL, O’Keeffe T, Friese RS, et al.. Two-year experience of using pigtail catheters to treat traumatic pneumothorax: a changing trend. J Trauma. 2011; 71:(5)1104–7. https://doi.org/10.1097/TA.0b013e31822dd130
     [Google الباحث العلمي]
  10. Kulvatunyou N, Erickson L, Vijayasekaran A, Gries L, Joseph B, Friese RF, et al.. Randomized clinical trial of pigtail catheter versus chest tube in injured patients with uncomplicated traumatic pneumothorax. Br J Surg. 2014; 101:(2)17–22. https://doi.org/10.1002/bjs.9377
     [Google الباحث العلمي]
  11. Treml B, Rajsic S, Diwo F, Hell T, Hochhold C. Small drainage volumes of pleural effusions are associated with complications in critically ill patients: a retrospective analysis. J Clin Med. 2021; 10:(11)2453. https://doi.org/10.3390/jcm10112453
     [Google الباحث العلمي]
  12. Kulvatunyou N, Bauman ZM, Zein Edine SB, de Moya M, Krause C, Mukherjee K, et al.. The small (14 Fr) percutaneous catheter (P-CAT) versus large (28-32 Fr) open chest tube for traumatic hemothorax: a multicenter randomized clinical trial. J Trauma Acute Care Surg. 2021; 91:(5)809–13. https://doi.org/10.1097/TA.0000000000003180
     [Google الباحث العلمي]
  13. Liu YH, Lin YC, Liang SJ, Tu CY, Chen CH, Chen HJ, et al.. Ultrasound-guided pigtail catheters for drainage of various pleural diseases. Am J Emerg Med. 2010; 28:(8)915–21. https://doi.org/10.1016/j.ajem.2009.04.041
     [Google الباحث العلمي]
  14. Lin YC, Tu CY, Liang SJ, Chen HJ, Chen W, Hsia TC, et al.. Pigtail catheter for the management of pneumothorax in mechanically ventilated patients. Am J Emerg Med. 2010; 28:(4)466–71. https://doi.org/10.1016/j.ajem.2009.01.033
     [Google الباحث العلمي]
  15. Rivera L, O’Reilly EB, Sise MJ, Norton VC, Sise CB, Sack DI, et al.. Small catheter tube thoracostomy: effective in managing chest trauma in stable patients. J Trauma. 2009; 66:(2)393–9. https://doi.org/10.1097/TA.0b013e318173f81e
     [Google الباحث العلمي]
  16. Cho S, Lee EB. Management of primary and secondary pneumothorax using a small-bore thoracic catheter. Interact Cardiovasc Thorac Surg. 2010; 11:(2)146–9. https://doi.org/10.1510/icvts.2009.226589
     [Google الباحث العلمي]
  17. Cafarotti S, Dall’Armi V, Cusumano G, Margaritora S, Meacci E, Lococo F, et al.. Small-bore wire-guided chest drains: safety, tolerability, and effectiveness in pneumothorax, malignant effusions, and pleural empyema. J Thorac Cardiovasc Surg. 2011; 141:(3)683–7. https://doi.org/10.1016/j.jtcvs.2010.08.044
     [Google الباحث العلمي]
  18. Messa GE, Fontenot CJ, Deville PE, Hunt JP, Marr AB, Schoen JE, et al.. Chest tube size selection: evaluating provider practices, treatment efficacy, and complications in management of thoracic trauma. Am Surg. 2024; 90:(6)1501–7. https://doi.org/10.1177/00031348241241735
     [Google الباحث العلمي]
  19. Salé A, Sohier L, Campion M, Le Hô R, Bazin Y, Gangloff C, et al.. Exclusive ambulatory management of spontaneous pneumothorax with pigtail catheters, a prospective multicentric study. Respir Med. 2020; 166:105931. https://doi.org/10.1016/j.rmed.2020.105931
     [Google الباحث العلمي]
  20. Li X, Chen X, He S, Chen H. The application of pigtail catheters in postoperative drainage of lung cancer. Clin Lung Cancer. 2022; 23:(3)e196–202. https://doi.org/10.1016/j.cllc.2021.07.010
     [Google الباحث العلمي]
  21. Bauman ZM, Kulvatunyou N, Joseph B, Jain A, Friese RS, Gries L, et al.. A prospective study of 7-year experience using percutaneous 14-french pigtail catheters for traumatic hemothorax/hemopneumothorax at a level-1 trauma center: size still does not matter. World J Surg. 2018; 42:(1)107–13. https://doi.org/10.1007/s00268-017-4168-3
     [Google الباحث العلمي]
  22. Keeling AN, Leong S, Logan PM, Lee MJ. Empyema and effusion: outcome of image-guided small-bore catheter drainage. Cardiovasc Intervent Radiol. 2008; 31:(1)135–41. https://doi.org/10.1007/s00270-007-9197-0
     [Google الباحث العلمي]
  23. Kulvatunyou N, Joseph B, Friese RS, Green D, Gries L, O’Keeffe T, et al.. 14 French pigtail catheters placed by surgeons to drain blood on trauma patients: is 14-Fr too small? J Trauma Acute Care Surg. 2012; 73:(6)1423–7. https://doi.org/10.1097/TA.0b013e318271c1c7
     [Google الباحث العلمي]
  24. Horsley A, Jones L, White J, Henry M. Efficacy and complications of small-bore, wire-guided chest drains. Chest. 2006; 130:(6)1857–63. https://doi.org/10.1378/chest.130.6.1857
     [Google الباحث العلمي]
  25. Vedam H, Barnes DJ. Comparison of large- and small-bore intercostal catheters in the management of spontaneous pneumothorax. Intern Med J. 2003; 33:(11)495–9. https://doi.org/10.1046/j.1445-5994.2003.00467.x
     [Google الباحث العلمي]
  26. Liang SJ, Tu CY, Chen HJ, Chen CH, Chen W, Shih CM, et al.. Application of ultrasound-guided pigtail catheter for drainage of pleural effusions in the ICU. Intensive Care Med. 2009; 35:(2)350–4. https://doi.org/10.1007/s00134-008-1314-2
     [Google الباحث العلمي]
  27. Mortman KD, Tanenbaum MT, Cavallo KM, Kelley D, Bonitto SS, Sadur A, et al.. Reintervention rate after pigtail catheter insertion compared to surgical chest tubes. Am Surg. 2023; 89:(12)5487–91. https://doi.org/10.1177/00031348231157419
     [Google الباحث العلمي]
  28. Jayakrishnan B, Kashoob M, Al-Sukaiti R, Al-Mubaihsi S, Kakaria A, Al-Ghafri A, et al.. Percutaneous ultrasound-guided pigtail catheter for pleural effusions: efficacy and safety. Oman Med J. 2021; 36:(2)e248. https://doi.org/10.5001/omj.2021.19
     [Google الباحث العلمي]
  29. Chen CH, Liao WC, Liu YH, Chen WC, Hsia TC, Hsu WH, et al.. Secondary spontaneous pneumothorax: which associated conditions benefit from pigtail catheter treatment? Am J Emerg Med. 2012; 30:(1)45–50. https://doi.org/10.1016/j.ajem.2010.09.014
     [Google الباحث العلمي]
  30. Orlando A, Cordero J, Carrick MM, Tanner AH, Banton K, Vogel R, et al.. Comparing complications of small-bore chest tubes to large-bore chest tubes in the setting of delayed hemothorax: a retrospective multicenter cohort study. Scand J Trauma Resusc Emerg Med. 2020; 28:(1)56. https://doi.org/10.1186/s13049-020-00754-5
     [Google الباحث العلمي]
  31. Bauman ZM, Kulvatunyou N, Joseph B, Gries L, O’Keeffe T, Tang AL, et al.. Randomized clinical trial of 14-french (14F) Pigtail catheters versus 28-32F chest tubes in the management of patients with traumatic hemothorax and hemopneumothorax. World J Surg. 2021; 45:(3)880–6. https://doi.org/10.1007/s00268-020-05852-0
     [Google الباحث العلمي]
  32. Rafiq S, Dar MA, Nazir I, Shaffi F, Shaheen F, Kuchay IA. Image-guided catheter drainage in loculated pleural space collections, effectiveness, and complications. Lung India. 2020; 37:(4)316–22. https://doi.org/10.4103/lungindia.lungindia_385_19
     [Google الباحث العلمي]
  33. Cantin L, Chartrand-Lefebvre C, Lepanto L, Gianfelice D, Rabbat A, Aubin B, et al.. Chest tube drainage under radiological guidance for pleural effusion and pneumothorax in a tertiary care university teaching hospital: review of 51 cases. Can Respir J. 2005; 12:(1)29–33. https://doi.org/10.1155/2005/498709
     [Google الباحث العلمي]
  34. Jain S, Deoskar RB, Barthwal MS, Rajan KE. Study of pigtail catheters for tube thoracostomy. Med J Armed Forces India. 2006; 62:(1)40–1. https://doi.org/10.1016/S0377-1237(06)80153-X
     [Google الباحث العلمي]
  35. Tajarernmuang P, Gonzalez AV, Valenti D, Beaudoin S. Overuse of small chest drains for pleural effusions: a retrospective practice review. Int J Health Care Qual Assur. 2021. https://doi.org/10.1108/IJHCQA-11-2020-0231
     [Google الباحث العلمي]
  36. Bateman M, Alkhatib A, John T, Parikh M, Kheir F. Pleural effusion outcomes in intensive care: analysis of a large clinical database. J Intensive Care Med. 2019; 35:48–54.
    [Google الباحث العلمي]
  37. Thomas R, Jenkins S, Eastwood PR, Lee YC, Singh B. Physiology of breathlessness associated with pleural effusions. Curr Opin Pulm Med. 2015; 21:(4)338–45. https://doi.org/10.1097/MCP.0000000000000174
     [Google الباحث العلمي]
  38. Bediwy AS, Al-Biltagi M, Saeed NK, Bediwy HA, Elbeltagi R. Pleural effusion in critically ill patients and intensive care setting. World J Clin Cases. 2023; 11:(5)989–99. https://doi.org/10.12998/wjcc.v11.i5.989
     [Google الباحث العلمي]
  39. McKnight CL, Burns B. Pneumothorax. 2023 Feb 15. In: StatPearls. Treasure Island, FL:StatPearls Publishing;2024.
    [Google الباحث العلمي]
  40. Farjah F, Symons RG, Krishnadasan B, Wood DE, Flum DR. Management of pleural space infections: a population-based analysis. J Thorac Cardiovasc Surg. 2007; 133:(2)346–51. https://doi.org/10.1016/j.jtcvs.2006.09.038
     [Google الباحث العلمي]
  41. Filosso PL, Sandri A, Guerrera F, Ferraris A, Marchisio F, Bora G, et al.. When size matters: changing opinion in the management of pleural space-the rise of small-bore pleural catheters. J Thorac Dis. 2016; 8:(7)E503–10. https://doi.org/10.21037/jtd.2016.06.25
     [Google الباحث العلمي]
  42. Altmann ES, Crossingham I, Wilson S, Davies HR. Intra-pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult parapneumonic effusions and empyema. Cochrane Database Syst Rev. 2019; 2019:(10)CD002312. https://doi.org/10.1002/14651858.CD002312.pub4
     [Google الباحث العلمي]
  43. Alsaiedi AJ, Ferndez JA, Rehman MU, Bugami SA. Iatrogenic perforation of the left ventricle following chest drain insertion. J Cardiol Curr Res. 2017; 9:1–10.
    [Google الباحث العلمي]
  44. Beeton G, Ngatuvai M, Breeding T, Andrade R, Zagales R, Khan A, et al.. Outcomes of pigtail catheter placement versus chest tube placement in adult thoracic trauma patients: a systematic review and meta-analysis. Am Surg. 2023; 89:(6)2743–54. https://doi.org/10.1177/00031348231157809
     [Google الباحث العلمي]
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Failure rate and complications of small-bore, wire-guided chest drains in adult patients presenting with traumatic and nontraumatic pleural diseases: A systematic review
Qatar Medical Journal 2025, 55 (٢٠٢٥); https://doi.org/10.5339/qmj.2025.55
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  • نوع المستند: Review Article
الموضوعات الرئيسية chest, complications, failure rate, pigtail, pleural diseases, Small-bore catheter, small-bore chest drain and thorax

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