EVALUATION OF CONVENTIONAL CHEST TUBE THERAPY FOR LATROGENIC PNEUMOTHORAX

Study objective: To assess conventional, large chest tube therapy in i atrogenic pneumothorax and to determine the optimal moment when to use more invasive procedures. Design: Retrospective chart review. Setting : Medical intensive care unit of a university hospital. Patients: Fort y-seven patients with needle-induced iatrogenic pneumothorax. Twenty-f our patients had an underlying pleural or pulmonary disorder. Interven tions: After insertion of a 20- to 24-French plastic chest tube connec ted to an underwater seal, suction was maintained until gas egress sto pped or up to 10 days in patients with a persisting gas leak. Results: In 96 percent, a definite occlusion of the pneumothorax was achieved. in all patients without an underlying lung disorder, gas egress stopp ed definitely after 72 h. In the presence of an underlying lung disord er, 92 percent of the pneumothoraces were healed after 10 days of cont inuous suction therapy. At 72 h, only 71 percent of the latter group w ere healed (p<0.05 vs patients without lung disease). No major complic ation of chest tube therapy occurred. Conclusion: Conventional chest t ube therapy is a safe and effective treatment for iatrogenic pneumotho rax. In patients with an underlying lung disease, gas egress may last for up to 10 days. In these patients, the earlier use of a more invasi ve approach may be justified if the air leak persists.