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J Korean Soc Emerg Med > Volume 26(6); 2015 > Article
Journal of The Korean Society of Emergency Medicine 2015;26(6): 577-584.
일차 자발기흉 환자에서 소구경 카테터 흉강삽입술과 가슴관 흉강삽관술의 재팽창성 폐부종 발생 비교
고석훈1, 박현경1, 이창민1, 박성혁1, 정웅1, 김명천1, 고영관1, 김대현2
1경희대학교 의과대학 강동경희대병원 응급의학과
2경희대학교 의과대학 강동경희대병원 흉부외과
Reexpansion Pulmonary Edema after Initial Treatment of Primary Spontaneous Pneumothorax: Small Bore Catheterization versus Chest Tube Thoracostomy
Seok Hoon Ko1, Hyun Kyung Park1, Chang Min Lee1, Sung Hyuk Park1, Woong Jung1, Myung Chun Kim1, Young Gwan Ko1, Dae Hyun Kim2
1Department of Emergency Medicine, Kyung Hee University Hospital at Kangdong, College of Medicine, Kyung Hee University, Seoul, Korea
2Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Kangdong, College of Medicine, Kyung Hee University, Seoul, Korea
Correspondence  Hyun Kyung Park ,Tel: 02) 440-7790, Fax: 02) 440-7799, Email: emhyun@khnmc.or.kr,
Received: July 31, 2015; Revised: August 4, 2015   Accepted: September 26, 2015.  Published online: December 30, 2015.
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.
Method:
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.
Key words: Pulmonary edema, Pneumothorax, Catheterization, Chest tubes
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