types of pigtail catheter


Normal liquid and protein enter pleura space from the systemic circulation and are removed by the parietal pleural lymphatics. Gammie et al. The set comes with the Cook Chest Drain Valve, which is designed to help remove air from the pleural cavity. Therefore, we place most pigtail catheters in the 4th-6th intercostal space in the mid-axillary line for maximum patient comfort and ease of insertion. Informed signed consent was obtained from all patients eligible to participate in the study. In our study, it was found that among the nine cases of failure, five of them were due to loculated effusions, and four of them were due to rapid reaccumulation of the fluid after removal of the catheter. Experience on the liver transplant service at our institution suggested that pneumothoraces and simple effusions could be successfully treated with the 8.3 F pigtail catheter.

By clicking Submit, you agree to the terms and conditions for collecting and processing your personal information, as included in our customer data privacy notice. Features and benefits [5] found that five percent of pigtail catheter placements were associated with serious complications (hemothorax, pnuemothorax, and hepatic perforation) and the overall complications of catheter use occurred in 20% of patients and included failure to drain, dislodgement, kinking, empyema, and disconnection. The objective of this study was to evaluate the efficacy of the pigtail catheter as an alternative to tube thoracostomy for pneumothoraces and simple effusions. A lateral decubitus chest radiograph is a rapid and simple way of assuring that an effusion is free-flowing and, therefore, likely to respond to pigtail drainage. Features and benefits In the present study, complications of pigtail catheter insertion included pain at the insertion site requiring analgesia (45.09%), pneumothorax (19.6%), blockage of the catheter (3.92%), and infection (1.96%). Chest tubes, with their excessive size, cause pain by compressing the neurovascular bundle at the top of the interspace, as well as by levering open the interspace. The set comes with the Cook Chest Drain Valve, which is designed to help remove air from the pleural cavity. . Tube thoracostomy remains the standard of care for the treatment of pneumothorax and simple effusions in most hospitals [4]. Roberts et al. The incidence of infection was 2.2%. Liu et al. Nonlayering effusions should be drained with radiographie guidance. Seventy-seven effusions and 32 pneumothoraces were treated with pigtail catheters. The incidence and significance of pneumothorax after small-bore catheter placement for malignant pleural effusions was examined by Chang et al. 5 * We restrict the use of the pigtail catheter for patients with pneumothoraces and for those with nonloculated simple effusions. Needles were inserted just above the top of the rib to avoid injury of the intercostal bundle. Because the mesothelial boundaries are leaky, excess liquid can move across into the lower pressure (intrapleural), high-capacitance space and collect as a pleural effusion. Serial radiography showed persistence of the effusion with failure of the drainage. 58-year-old male with empyema with loculations. [22] demonstrated that pigtail catheter insertion may hasten resolution of tuberculous pleural effusion and reduce the occurrence of residual pleural thickening. Seldinger placement facilitates controlled, minimally invasive catheter introduction. The most proximal side hole is positioned on the radiopaque stripe to aid in confirming catheter positioning via x-ray. 4 *Kulvatunyou N, Vijayasekaran A, Hansen A, et al. The 8.3 F pigtail catheter is now our method of choice for draining air and free-flowing simple effusions from the pleural space. Saffran et al. Used to infuse or withdraw rinsing solutions in theperitoneal cavity. You will be leaving the Cook Medical website that you were viewing and going to a Cook Medical website for another region or country. Eight of 13 effusions were adequately treated using the small-bore catheter, compared with four of 11 effusions treated with the standard chest tube. Treatment of pneumothoraces utilizing small caliber chest tubes, Chest tubes: indications, techniques, management and complications, Chest tube insertion: a prospective evaluation of pain management, JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons, http://creativecommons.org/licenses/by-nc-nd/3.0/, Persistent PTX after 72 hours, resolved with CT, Ongoing air leak/PTX at 48 hours, 2nd pigtail unsuccessful, 2 Cts placed: persistent air leak; ARDS, death, advanced COPD, pneumonia, PTX after central line, Persistent PTX/air leak at 48 hours; required 3 Cts / 19 days to resolve PTX, anorectal cancer, PTX after central line placement, Initial success; recurrent PTX at 96 hours (pigtail sideholes migrated outside thorax); resolved with CT, 3 days s/p CABG; bilat PTX after CT removal, Left pigtail successful; right pigtail failed; CT successful, Pigtail # drained 550 cc/24hrs, then displaced to chest wall Pigtail #2: minimal drainage; CT & CAT-guided pigtail successful, Pigtail successful, removed with 1 liter/day output; 2nd pigtail successful, metastatic breast cancer: bilateral effusions, Left pigtail successful; Right failed: loculated collection required ultrasound-guided drainage w/ 8F catheter, Effusion drained: persistent air leak resolved with 2nd pigtail, Minimal drainage with pigtail; CT also failed: thoracotomy for large hemothorax, Pigtail sideholes extrapleural; CT unsuccessful; U/S guided thoracentesis fails: death from sepsis, Effusion resolved with pigtail: removed 48 hours after placement; pneumothorax 24 hours later resolved w/ CT, 1 month s/p hepatic lobectomy: R effusion, U/S catheter drainage failed; pigtail->partial drainage; CAT-guided 10F catheters x 2 failed (loculated collection); VATS successful, Pigtail successful 72 hours: pulled out on bedrail; residual fluid removed with thoracentesis, Pigtail successful, removed with 1600 cc/day output; second pigtail successful. 5 The only positive effect found in the drainage group was a more rapid resolution of dyspnoea. Used in conjunction with a pneumothorax aspiration catheter if incomplete expansion of the lung persists after mechanical aspiration of air. This form is intended for US-based physicians only. PMC legacy view The site of catheter insertion was determined according to ultrasound findings. All procedures were done at the bedside under local anesthesia with 3 to 6mL of lidocaine 2% and with ultrasonic guidance. Seldinger placement facilitates controlled, minimally invasive catheter introduction. [12] used a 14F pigtail catheter in ten patients with malignant pleural effusion in an ambulatory base and after that pleurodesis was done with talc.

[23] found that pigtail catheter insertion for cases of tuberculous pleural effusion had no beneficial effects on residual pleural thickening development and did not shorten the duration of fever. See http://creativecommons.org/licenses/by-sa/3.0/ for details. It is packaged with a needle, guidewire, and dilator for insertion using the modified Seldinger technique as well as a serrated, tapered catheter connector which allows easy attachment of the catheter to a standard thoracic drainage system. The diagnosis of pleural effusion was based on clinical and chest X-ray findings and confirmed by a diagnostic thoracocentesis (less than 50mL). Read the winning articles. It has previously been shown that routine chest tube placement is frequently associated with an unacceptable pain level.10. Sargent reported using a 9 F catheter to treat pneumothoraces in 1970.3 Lawless and colleagues from the University of Pittsburgh used an 8.5 F pigtail catheter for the treatment of pneumothorax in 16 neonates and small children with a high success rate.4 Robinson applied Tenckhoff catheters for palliative drainage of malignant pleural effusion in nine patients.5 Martin reported the use of a small-bore 13 F catheter with an integral one-way valve for the treatment of simple pneumothoraces in 84 patients.6 All catheters were placed in the second intercostal space in the midclavicular line. Source: Regenstrief LOINC, LP21378-2 Catheter 67-year-old male with transudative effusion due to hypoproteinemia caused by chronic liver disease. The catheter is equipped with 90 sideports. In contrast, the 8.3 F pigtail catheter has a diameter of only 2.8 mm and does not impinge on the neurovascular bundle or alter the geometry of the intercostal space (Figure 2). Exclusion of the two patients (three catheter placements) with severe underlying parenchymal disease and prevention of pigtail migration in the fourth would have yielded a success rate of 30/32, or 94% for pneumotho-races. 9 In our hands, the pigtail catheter yielded rapid radiographie resolution of both pneumothoraces and pleural effusions. [11] found that eleven out of 77 pigtail catheter placements for pleural effusions were not successful. Fourteen cases had transudative pleural effusion; eight secondary to heart failure and six secondary to hypoproteinemia. [10] reviewed 276 patients who underwent pigtail catheters (size from ten to 16 French) under ultrasound guidance for drainage of pleural effusions of various etiologies and pneumothoraces.

Success using the pigtail catheter demands adherence to proper patient selection and attention to details at the time of insertion. Blockage of the catheters and infection were associated with procedure failure. There was no significant difference in success rate when different catheter sizes were used to treat pleural diseases. Failure to produce radiographie improvement should prompt insertion of either a second pigtail or a chest tube. 45-year-old male with tuberculous pleural effusion (loculated). HHS Vulnerability Disclosure, Help Trial of clearing the catheter using the guide wire failed. In two cases, pigtail catheters were removed when they were draining in excess of 1000 ml of fluid per day, and the underlying effusions re-accumulated. Among the six cases of empyema, the procedure was successful only in two of them (success rate 33.33%). 59-year-old male with empyema with loculations. Complications of pigtail catheter included pain at the insertion site requiring analgesia in 23 patients, pneumothorax in ten patients, blockage of the catheter in two patients, and infection in one patient (Table 1). View more details about the SimplePneumothoraxAspiration Accessory Set. Different catheters have different combinations of stiffness, diameter, angle and shape.

We reviewed all consecutive inpatient pigtail catheter insertions performed between January and October 1996 at the University of Pittsburgh Medical Center. The radiopaque catheter material enhances x-ray visualization. A pleural effusion is always abnormal and indicates the presence of an underlying disease. Used to remove fluid from the pericardial sac. 2011;71(5):11041107. Two-year experience of using pigtail catheters to treat traumatic pneumothorax: a changing trend. A favorable initial experience stimulated broader application of this technique, and the pigtail catheter now enjoys acceptance for chest drainage in a variety of clinical settings. On the contrary, Lai et al. . The catheter material has radiopaque properties. Clinical details of patients not responding to initial pigtail catheter placement (therapeutic failures). One should have a low threshold for additional radiographie study of a pleural fluid collection that does not respond to initial drainage maneuvers.