Journal Review in Trauma Surgery: Pigtail Catheters for Traumatic Hemothorax

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 11 October 2021

⏱️ 30 minutes

🔗️ Recording | iTunes | RSS

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Summary

Large diameter 26-32Fr chest tubes are the treatment of choice at many institutions for the treatment of traumatic hemothorax, but does the currently available data support that? Are there better options available? Join our team as we discuss the The Small 14-French (Fr) Percutaneous Catheter vs. Large (28-32Fr) Open Chest Tube for Traumatic Hemothorax (P-CAT): A Multi-center Randomized Clinical Trial by Dr. N Kulvatunyou et al to address this question.

Hosts:
Elliott R. Haut, MD, PhD, a senior, nationally recognized name in trauma and acute care surgery at Johns Hopkins University. Dr. Haut is a past president of The Eastern Association for the Surgery of Trauma (EAST).

Marcie Feinman, MD, MEHP, the current program director of General Surgery Residency at Sinai Hospital of Baltimore and editorial board member of SCORE. She received her Masters in Education in the Health Professions from Johns Hopkins.

David Sigmon, MD, MMEd, a PGY-6 resident at the University of Illinois at Chicago who plans on going into trauma surgery. He did two years of research in surgical education at the University of Pennsylvania where he also received his Master’s in Medical Education.

Journal Articles
The Small 14-French (Fr) Percutaneous Catheter vs. Large (28-32Fr) Open Chest Tube for Traumatic Hemothorax (P-CAT): A Multi-center Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/33843831/

Randomized Clinical Trial of 14-French (14F) Pigtail Catheters versus 28-32F Chest Tubes in the Management of Patients with Traumatic Hemothorax and Hemopneumothorax. https://pubmed.ncbi.nlm.nih.gov/33415448/

Randomized clinical trial of pigtail catheter versus chest tube in injured patients with uncomplicated traumatic pneumothorax. https://pubmed.ncbi.nlm.nih.gov/24375295/

14 French pigtail catheters placed by surgeons to drain blood on trauma patients: is 14-Fr too small?
https://pubmed.ncbi.nlm.nih.gov/23188235/

A Prospective Study of 7-Year Experience Using Percutaneous 14-French Pigtail Catheters for Traumatic Hemothorax/Hemopneumothorax at a Level-1 Trauma Center: Size Still Does Not Matter
https://pubmed.ncbi.nlm.nih.gov/28795207/

A History of Thoracic Drainage: From Ancient Greeks to Wound Sucking Drummers to Digital Monitoring https://www.ctsnet.org/article/history-thoracic-drainage-ancient-greeks-wound-sucking-drummer s-digital-monitoring

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Transcript

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0:00.0	This episode is brought to you by Kraken.
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0:26.0	This is a high risk investment and you should not expect to be protected if something goes wrong.
0:30.0	Behind the knife the surgery podcast where we take a behind the scenes intimate look at surgery from leaders in the field.
0:52.0	Welcome to Behind the Knife trauma edition.
0:54.0	This is our team's second podcast and we are excited to continue to share our expertise and trauma with you.
1:00.0	My name is Marcy Feyman and I am a trauma and acute care surgeon in Baltimore, Maryland, as well as the general surgery residency program director at Sinai Hospital.
1:08.0	I am joined by Dr. David Sigmund, PGY4 at University of Illinois at Chicago and education guru, as well as Dr. Elliott Hought, trauma surgeon extraordinaire from Johns Hopkins and past president of the Eastern Association for the surgery of trauma.
1:22.0	Together, we will be your host in this episode as we discuss the evidence behind the use of pigtail catheters for human thorax secondary to trauma.
1:30.0	Well, there have been several small studies that looked at whether pigtail catheters are feasible to dream human thoracies over the past 10 years.
1:37.0	In March 2021, Dr. Colvetunio and colleagues led a multi center randomized control trial that looked at whether pigtail catheters performed as well as large board tubes.
1:48.0	So let's get started. David, why don't you tell us a bit about how we got here.
1:52.0	Thank you, Marcy, for that great introduction.
1:54.0	This is actually, it sounds like a basic topic, it was actually quite interesting.
1:58.0	You know, chest tubes, you think of them as a relatively recent development, but they're actually first described by apocrates, about 200, 300 BC, when you talk about using a need during an MPIema and then eventually plugging the wound with linen.
2:12.0	Historically, interest in this procedure kind of waxed and waned and medieval times actually went away from tubes and invented something called wound suckers.
	...

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