TY - JOUR
T1 - A Novel Device for Accurate Chest Tube Insertion
T2 - A Randomized Controlled Trial
AU - Katballe, Niels
AU - Møller, Lars Borgbjerg
AU - Olesen, Winnie H
AU - Litzer, Marina M
AU - Andersen, Gratien
AU - Nekrasas, Vytautas
AU - Licht, Peter B
AU - Bach, Peter
AU - Pilegaard, Hans K
N1 - Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
PY - 2016
Y1 - 2016
N2 - BACKGROUND: Optimal positioning of a large-bore chest tube is in the part of the pleural cavity that needs drainage. It is recommended that the chest tube be positioned apically in pneumothorax and basally for fluids. However, targeted chest tube positioning to a specific part of the pleural cavity can be a challenge.METHODS: A new medical device, the KatGuide, was developed for accurate guiding of a chest tube (28F) to an intended part of the pleural cavity. The primary end point of this randomized, controlled trial was optimal position of the chest tube. The optimal position in pneumothorax was apical (above the aortic arch), and the optimal position in hemothorax, hydrothorax, chylothorax, or empyema was basal (2 cm above the diaphragm or lower). The patients were randomized for the KatGuide method or the conventional forceps method, and rates of optimal position were compared.RESULTS: A total of 109 patients were enrolled (KatGuide: n = 49; conventional: n = 60). Chest tubes were optimally position in 41 (84%) in the KatGuide group vs 32 (53%) in the conventional group (p = 0.001). Experienced operators (>50 previous chest tube insertions) inserted 39 of the chest tubes, of which, 15 of 17 (88%) were optimally positioned in the KatGuide group vs 11 of 22 (50%) in the conventional group (p = 0.02). Two chest tubes (4%) were misplaced in the KatGuide group vs 11 (18%) in the conventional group (p = 0.04). No adverse device effects were observed.CONCLUSIONS: The KatGuide significantly improves the probability of optimal chest tube position and reduces the risk of misplacement compared with the conventional method. ClinicalTrial.gov Trial Registration Number: NCT01522885.
AB - BACKGROUND: Optimal positioning of a large-bore chest tube is in the part of the pleural cavity that needs drainage. It is recommended that the chest tube be positioned apically in pneumothorax and basally for fluids. However, targeted chest tube positioning to a specific part of the pleural cavity can be a challenge.METHODS: A new medical device, the KatGuide, was developed for accurate guiding of a chest tube (28F) to an intended part of the pleural cavity. The primary end point of this randomized, controlled trial was optimal position of the chest tube. The optimal position in pneumothorax was apical (above the aortic arch), and the optimal position in hemothorax, hydrothorax, chylothorax, or empyema was basal (2 cm above the diaphragm or lower). The patients were randomized for the KatGuide method or the conventional forceps method, and rates of optimal position were compared.RESULTS: A total of 109 patients were enrolled (KatGuide: n = 49; conventional: n = 60). Chest tubes were optimally position in 41 (84%) in the KatGuide group vs 32 (53%) in the conventional group (p = 0.001). Experienced operators (>50 previous chest tube insertions) inserted 39 of the chest tubes, of which, 15 of 17 (88%) were optimally positioned in the KatGuide group vs 11 of 22 (50%) in the conventional group (p = 0.02). Two chest tubes (4%) were misplaced in the KatGuide group vs 11 (18%) in the conventional group (p = 0.04). No adverse device effects were observed.CONCLUSIONS: The KatGuide significantly improves the probability of optimal chest tube position and reduces the risk of misplacement compared with the conventional method. ClinicalTrial.gov Trial Registration Number: NCT01522885.
UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-84973411542&origin=inward&txGid=03EB75B4FE440F5A345F107F454ED6B1.wsnAw8kcdt7IPYLO0V48gA%3a226
U2 - 10.1016/j.athoracsur.2015.07.017
DO - 10.1016/j.athoracsur.2015.07.017
M3 - Journal article
C2 - 26409714
SN - 0003-4975
VL - 101
SP - 527
EP - 532
JO - The Annals of thoracic surgery
JF - The Annals of thoracic surgery
IS - 2
ER -