Chest
Clinical InvestigationsTreatment of Pneumothoraces Utilizing Small Caliber Chest Tubes
Section snippets
Materials and Methods
From April 1981 to September 1987, a total of 84 pneumothoraces in 79 patients were treated with small caliber chest tubes. Of this group, 56 were men and 28 were women. Their ages ranged from 21 to 85 years, with an average age of 57.2 years. The causes of the pneumothoraces were as follow: percutaneous needle biopsy (54), spontaneous (14), central line placement (eight), barotrauma (three), postthoracotomy (two), bronchoscopic biopsy (one), mediastinoscopy (one), and intercostal nerve block
Results
Of the 84 small chest tubes inserted, 73 (87 percent) provided definitive treatment of the pneumothorax. Eleven small chest tubes were placed which required some form of additional intervention to treat the pneumothorax. Four of the tubes failed to evacuate any of the pneumothorax. Two of these folded back on themselves in the pleural space which kinked and occluded the tube. Another tube was placed in the major fissure, and subsequently, would not evacuate air. The fourth tube in this group
Discussion
The use of small caliber chest tubes in the treatment of pneumothoraces was initially described by Sargent and Turner.6 They employed a No. 9 French catheter in combination with a flutter valve developed by Heimlich.7 This sytem was easy to insert and required minimal nursing care after placement.
Since then, several series have been reported employing chest tubes (No. 12 to 20 French) and a Heimlich valve in the treatment of spontaneous pneumothoraces.1, 2, 8 These found that the Heimlich valve
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Manuscript received November 5; revision accepted January 20.