ULTRASOUND VS NON-ULTRASOUND PIGTAIL CATHETERS INSERTION FOR PNEUMOTHORAX MANAGEMENT

Abstract

SESSION TITLE: Disorders of the Pleura Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Determining the etiology of pneumothorax dictates immediate and definitive management. As such, tube thoracostomy has become the initial used modality for pneumothorax. Choosing between Ultrasound (US) or not US guided thoracostomy for pneumothorax insertion varies significant between institutions, experienced personnel, and pneumothorax type. Pigtail catheters offer a safe and effective alternative for large-bore chest tubes to patients experiencing pneumothorax. In this study, we aimed to assess the rate of complications between US and non-US Guided pigtail insertion for pneumothorax. METHODS: A retrospective analysis was performed of tube thoracostomy for treatment of pneumothorax in adult patients completed at a tertiary referral center. Data relating to intra and post-procedural complications and the need of alternative or further interventions were extracted from the institutional database. Complications were assessed using a multivariate logistic regression accounting for confounders between US and non-US guided thoracostomy. RESULTS: A total 218 pigtail catheters for treatment of pneumothorax were performed in 200 unique patients (120 patients underwent non-US-guided and 80 US-guided catheter insertion). One Hundred ten (55.0%) were placed by the Thoracic Surgery group and fifty-four (27.0%) by the Interventional Pulmonary group. A total of 18 (9.0%) patients suffered minor complications after chest tube insertion, 12 (10.0%) in the non-US group and 6 (7.5%) in the US group (p=0.724). None of the patients developed major complications. After adjusting for age, gender, and pneumothorax type there were no statistically significant association between US-Guided pigtail insertion and minor complications (OR 0.67 [CI: 0.23-1.97]). CONCLUSIONS: Our study suggests that there is no statistically significant difference between US and non-US guided small-bore catheters insertion for pneumothorax. Nevertheless, there may be a clinically significant reduction in complications with US guided pigtail catheters. CLINICAL IMPLICATIONS: There may be a clinically significant reduction in complications with US vs non US guided pigtail catheters. DISCLOSURES: No relevant relationships by Alvaro Ayala, source=Web Response No relevant relationships by Alex Chee, source=Web Response No relevant relationships by Fayez Kheir, source=Web Response Consultant relationship with Boston Scientific Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with olympus Please note: $5001 - $20000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with pinacle biologics Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with cook medical Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee No relevant relationships by Mihir Parikh, source=Web Response No relevant relationships by Priya Patel, source=Web Response