Comparison of pigtail percutaneous versus traditional chest tube thoracotomy for pneumothorax drainage in neonates

Abstract

Objective: Pigtail seldinger over the wire technique chest drains have been shown to be as effective and less invasive in adults than traditional chest tube thoracotomy. We aimed to compare conventional and pigtail chest tube management of pneumothorax in neonates. Methods: Retrospective comparison of pigtail and conventional chest tubes in neonates with pneumothorax in a tertiary neonatal intensive care unit. Results: 28 chest tubes were inserted in 18 neonates (23-39 weeks) including 12 conventional and 16 pigtail chest drains. Significantly increased analgesia was required while conventional chest drains were in situ compared to pigtail tubes. In addition 6 pneumothoraces were unresolved with conventional drains versus 1 following pigtail drain insertion. Conclusion: Optimising management of acute pneumothorax would improve neonatal morbidity and mortality. The use of the smaller and more flexible pigtail thoracostomy may minimise lung injury during insertion and decrease analgesia requirements.