Summary of complication rates and use of TUS
| (A) Complications of chest drain insertion | |||
|---|---|---|---|
| All drains; n=1394; (%) | Drains for pneumothorax; n=368; (%) | Drains for pleural effusion; n=1026; (%) | |
| Immediate complications | |||
| Iatrogenic haemothorax | 18 (1.3) | 1 (0.5) | 17 (1.7) |
| Pain | 112 (8) | 45 (12.2) | 67 (6.5) |
| Symptomatic hypotension | 16 (1.9) | 7 (1.9) | 19 (1.9) |
| Organ puncture | 9 (0.6) | 2 (0.5) | 7 (0.7) |
| Failure to place drain in pleural space | 28 (2.0) | 9 (2.4) | 19 (1.9) |
| Iatrogenic pneumothorax | NA | NA | 43 (4.2) |
| Delayed complications | |||
| Drain fell out | 128 (9.2) | 26 (7.1) | 102 (10) |
| Pain | 217 (15.6) | 77 (20.9) | 140 (14) |
| Drain blocked | 114 (8.2) | 27 (7.3) | 87 (8.5) |
| Pleural space infection | 6 (0.4) | 4 (1.1) | 1 (0.1) |
| Skin infection | 14 (1) | 3 (0.8) | 11 (1.1) |
| Surgical emphysema | 59 (4.2) | 46 (12.5) | 13 (1.3) |
| Re-expansion pulmonary oedema | 8 (0.6) | 2 (0.5) | 6 (0.6) |
| Death | 2 (0.1) | 0 | 2 (0.2) |
| (B) Complications of pleural aspiration | |||
|---|---|---|---|
| All aspirations; n=1162; (%) | Diagnostic aspiration; n=931; (%) | Therapeutic aspiration; n=231; (%) | |
| Pain | 112 (5.0) | 33 (3.5) | 25 (7.8) |
| Symptomatic hypotension | 7 (0.6) | 4 (0.4) | 3 (0.9) |
| Organ puncture | 3 (0.3) | 3 (0.3) | 0 (0) |
| Dry tap/failed procedure | 43 (3.7) | 38 (4.1) | 5 (2.2) |
| Iatrogenic pneumothorax | 15 (1.3) | 14 (1.5) | 1 (0.4) |
| Haemothorax | 13 (1.1) | 13 (1.4) | 0 (0) |
| Chest wall haematoma | 12 (1.0) | 12 (1.3) | 0 (0) |
| (C) Ultrasound guidance for procedures for pleural fluid | ||||
|---|---|---|---|---|
| Procedure | Real-time bedside TUS (%) | TUS in radiology department (%) | Remote ‘X-marks the spot’ TUS (%) | No evidence of TUS guidance (%) |
| Chest drain insertion (n=994) | 467 (47) | 220 (22) | 164 (17) | 143 (14) |
| Diagnostic aspiration (n=930) | 438 (47) | 205 (22) | 101 (11) | 186 (20) |
| Therapeutic aspiration (n=318) | 226 (71) | 12 (4) | 44 (14) | 36 (11) |
| All procedures (n=2242) | 1131 (50) | 437 (20) | 309 (14) | 365 (16) |
TUS, thoracic ultrasound.