Does chest tube size matter in managing parapneumonic effusions?
Aims
This study aims to compare the ‘drainage time’: the time required to drain the effusion, with a small-bore (12F) chest tube or a conventional large-bore (20–24F) chest tube in patients with a parapneumonic effusion.
Methods
Data from 54 patients with parapneumonic effusions who had chest tubes inserted were collected retrospectively and analysed in a tertiary UK hospital.
Results
The drainage time was significantly less (p<0.01) with a large-bore chest tube (3.87 days) compared with a small-bore chest tube (5.3 days). Analysis also showed that the large-bore group had more complex parapneumonic effusions than the small-bore group, with higher lactate dehydrogenase (LDH) levels (9,043 versus 1,968 IU/L respectively) and lower glucose levels (3.37 versus 5.13 mmol/L respectively) (Table 1). There was no significant difference in mortality (p=0.54) or surgical referral rate (p=0.68) between the two groups.
Conclusions
Drainage time with a large-bore chest tube was significantly less than with a small-bore chest tube, despite the large-bore group having patients with more complex parapneumonic effusions. We recommend the use of a large-bore chest tube as the initial choice of chest tube size for the management of a patient with parapneumonic effusion.
Conflict of interest statement
Financial support or sponsorship: none. Conflict of interest: none.
- © Royal College of Physicians 2019. All rights reserved.
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