COMPARISON OF EFFICACY AND SAFETY BETWEEN SMALL BORE VS. LARGE BORE CHEST TUBES FOR THERAPEUTIC PLEURAL DRAINAGE
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Keywords
Chest tubes, Drainage, Efficacy, Large bore, Pleural, Safety, Small bore
Abstract
Background: Therapeutic pleural drainage involves the insertion of a chest tube to evacuate fluid or air from the pleural space, often utilized in the management of conditions such as pleural effusion or pneumothorax.
Objectives: To compare the efficacy and safety between small bore versus large bore chest tubes for therapeutic pleural drainage.
Study Design: Cross Randomized Controlled Trial (RCT).
Settings: The study was conducted at the Department of Pulmonology Services Hospital Lahore from January 2024 to June 2024.
Methods: A total of 110 patients, comprising 55 individuals in each group, were enrolled in this prospective comparative study. Patients presenting with pneumothorax, empyema, para-pneumonic effusion, or malignant effusion requiring therapeutic evacuation of the pleural space were included. Allocation to either the small bore (<20 F size) or large bore (>20 F size) chest tube group was randomized using a lottery method. Therapeutic drainage procedures were performed by experienced clinicians following standard protocols. Data including patient demographics, indications for drainage, tube insertion technique, duration of drainage, volume of fluid removed, and clinical outcomes were recorded. Collected data were processed and analyzed using IBM SPSS, version 27.0.
Results: The study comprised 73 (66.4%) males and 37 (33.6%) females. The mean age of participants was 48.49 ± 13.17 years for the small-bore chest tube group and 46 ± 12.72 years for the large-bore chest tube group. The small-bore chest tube group drained a higher proportion of effusions less than 1000 ml compared to the large-bore chest tube group (47.3% vs. 23.6%, p = 0.033). Furthermore, the small-bore chest tube group had significantly shorter dwell times (3.38 days vs. 7.95 days, p < 0.001) and shorter durations of hospital stay (3.95 days vs. 8.69 days, p < 0.001) compared to the large-bore chest tube group. The small-bore chest tube group demonstrated a higher rate of lung re-expansion compared to the large-bore chest tube group (70.9% vs. 54.5%, p = 0.076).
Conclusion: Small-bore chest tubes demonstrated significant advantages in patient comfort, shorter hospital stays, and fewer complications, while large-bore tubes were more effective for larger effusions. Tailoring the choice of chest tube to the clinical scenario can enhance patient outcomes
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Hafiza Kubra
MBBS, Women Medical Officer DHQ Hospital, Narowal,
Ahmad Ali
MBBS, FCPS (Thoracic Surgery), Assistant Professor Department of Thoracic Surgery Service Institute of Medical Sciences & Services Hospital Lahore
Aeman Sajjad
MBBS, Shaikh Zayed Hospital, Lahore,
Kainat Iqbal
MBBS from (MBBSMC Mirpur), FCPS-1 Medicine & Allied Demonstrator in Mohi-ud-Din Islamic Medical College, Mirpur, AJK,
Mubarik Ahmed Ayub
MBBS, FCPS-I Psychiatry MO in The Fairway Clinic,
Ayesha Masood
MBBS Shaikh Zayed Hospital, Lahore,