Comparison of Therapeutic Effects and Complications between Pigtail Catheter and Conventional Tube Thoracotomy for Pneumothorax in Neonates

ABSTRACT

PURPOSE: Pneumothorax develops frequently as a complication of respiratory diseases and in the course of management in newborn. We compared therapeutic effects and complications of conventional tube thoracotomy and Pigtail catheter inserted by modified Fuhrman's technique for pneumothorax in neonates. METHODS: We reviewed the clinical records of 22 infants with pneumothorax treated with tube thoracotomy and 14 infants with Pigtail catheter, admitted at Kangnarn Sacred Heart Hospital and ChunCheon Sacred Heart Hospital between Jan 1995 and Jul 1998. Sex ratio(13 9 vs. 7 7), gestational age(32.7+/-4.3 vs. 31.5+/-5.5 wks), birth weight(1906+/-1025 vs. 1836+/-1128 g) and the incidence of tension pneumothorax(68% vs. 59%) and spontaneous pneumothorax(18% vs. 35%) were not significantly different between two groups. RESULTS: The tube insertion time(5.1+/-4.8 vs. 4.3+/-4.1 days of life), duration of tube insertion(168+/-150 vs. 86+/-78 hrs), duration of mechanical ventilation after tube insertion (8.6+/-6.9 vs. 5.8 and mortality during tube insertion(65% vs. 43%) were not significantly different between tube thoracotomy group and Pigtail catheter inserted group. The complications such as hemothorax and pulmonary hemorrhage were found in 7 cases in tube thoracotomy group but none in Pigtail catheter inserted group. CONCLUSION: Conventional chest tube insertion for pneumothorax can often be traumatic, but Pigtail catheter insertion is safer and easier. Percutaneous placement of Pigtail catheters may be a useful alternative to the conventional method of thoracotomy tube placement in small infants.