Reexpansion Pulmonary Edema after Initial Treatment of Primary Spontaneous Pneumothorax: Small Bore Catheterization versus Chest Tube Thoracostomy.
- Author:
Seok Hoon KO
1
;
Hyun Kyung PARK
;
Chang Min LEE
;
Sung Hyuk PARK
;
Woong JUNG
;
Myung Chun KIM
;
Young Gwan KO
;
Dae Hyun KIM
Author Information
1. Department of Emergency Medicine, Kyung Hee University Hospital at Kangdong, College of Medicine, Kyung Hee University, Seoul, Korea. emhyun@khnmc.or.kr
- Publication Type:Original Article
- Keywords:
Pulmonary edema;
Pneumothorax;
Catheterization;
Chest tubes
- MeSH:
Catheterization*;
Catheters*;
Chest Tubes*;
Demography;
Drainage;
Humans;
Length of Stay;
Logistic Models;
Medical Records;
Pneumothorax*;
Pulmonary Edema*;
Retrospective Studies;
Thoracostomy*;
Thorax*;
Treatment Failure
- From:Journal of the Korean Society of Emergency Medicine
2015;26(6):577-584
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Reexpansion pulmonary edema (REPE) is a rare but potentially lethal complication of treatment for pneumothorax. This study was designed to compare the frequency of REPE after treatment of primary spontaneous pneumothorax (PSP) with 6 French (Fr) small bore catheterization and 14-20 Fr chest tube thoracostomy. METHODS: The medical records of PSP patients treated with thoracostomy from January 2010 to May 2015 were reviewed retrospectively. We compared the group treated using a 6 Fr small bore catheter with the group treated using a 14-20 Fr chest tube for clinical and demographic factors. The main outcome was the frequency of REPE between the two groups. RESULTS: A total of 196 patients were enrolled. No significant differences in catheter indwelling time, lengths of hospital stay, and treatment failures were observed between the two groups. REPE developed in 21 patients (10.7%). The frequencies of REPE after 6 Fr small bore catheter and 14-20 Fr chest tube were 6.0% (7 of 114 patients) and 17.1% (14 of 82 patients), respectively (p=0.015). In logistic regression analysis, drainage via 14-20 Fr chest tube showed significant correlation with the occurrence of REPE (odds ratio=3.03, p=0.038). CONCLUSION: A 6 Fr small bore catheter offers a safe and effective alternative to a chest tube for treatment of pneumothorax. We suggest that drainage via a small bore catheter should be considered as the initial treatment of choice for PSP patients in terms of frequency of development REPE.
