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J Korean Soc Emerg Med > Volume 16(1); 2005 > Article
Journal of The Korean Society of Emergency Medicine 2005;16(1): 152-157.
Small Caliber Catheter Drainage in the Treatment of a Spontaneous Pneumothorax
Hyun Wook Ryoo, Kang Suk Seo, Jeong Ho Lee, Kyung Woo Lee, Kyu Tae Kim, Jong Yeul Kim
1Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea. kssuh@knu.ac.kr
2Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
3Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Korea.
Small caliber catheter drainage is proposed and attempted as a alternative modality due to the invasiveness of a closed thoracostomy. The purpose of this study is to examine the effectiveness of a small caliber catheter (7.0 Fr), which is less invasive and relatively easy to use compared to a closed thoracostomy in the treatment of a spontaneous pneumothorax.
This study included 90 spontaneous pneumothorax patients who visited the Emergency Department of Kyungpook National University Hospital and who were treated with a small caliber catheter from January to December 2003. We investigated the success rate, the existence of underlying pulmonary disease, the total number of incidences at the time of visit, the size of the pneumothorax, the number of days to re-expansion, the days of hospitalization, and the rates of recurrence by reviewing the medical records retrospectively.
The mean age was 30.4+/-15.6 years old, and there were 79(87.8%) males and 11(12.2%) females with an average hospitalization of 3.25+/-3.16 days. The treatment succeeded in 61 patients (67.8%) and failed in the remaining 29. A conventional large caliber chest tube was inserted in 16 of the 29 failures, but it was successful in only 5. The success rate was 76.7%(23/30), 78.6%(33/42), and 27.8%(5/18) when the size of the pneumothorax was 20~39%, 40~79%, and greater than 80% of the volume of the pleural cavity, respectively (p=0.000). The other factors did not influence the outcome.
Small caliber catheter drainage can be considered as the initial treatment of choice for a spontaneous pneumothorax, especially for a pneumothorax with a size smaller than 80% of the volume of the pleural cavity.
Key words: Pneumothorax, Therapy, Thoracostomy, Catheterization
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