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Semin Respir Crit Care Med 2010; 31(6): 760-768
DOI: 10.1055/s-0030-1269836
© Thieme Medical Publishers

Optimal Chest Drain Size: The Rise of the Small-Bore Pleural Catheter

Edward T. H Fysh1 , 2 , Nicola A. Smith2 , Y. C Gary Lee1 , 2 , 3
  • 1School of Medicine and Pharmacology and CAARR, University of Western Australia, Perth, Australia
  • 2Respiratory Department, Sir Charles Gairdner Hospital, Perth, Australia
  • 3Pleural Disease Unit, Lung Institute of Western Australia, Perth, Australia
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Publication History

Publication Date:
06 January 2011 (online)

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ABSTRACT

Drainage of the pleural space is not a modern concept, but the optimal size of chest drains to use remains debated. Conventional teaching advocates blunt dissection and large-bore tubes; but in recent years, small-bore catheters have gained popularity. In the absence of high-quality randomized data, this review summarizes the available literature on the choice of chest drains. The objective data supporting the use of large-bore tubes is scarce in most pleural diseases. Increasing evidence shows that small-bore catheters induce less pain and are of comparable efficacy to large-bore tubes, including in the management of pleural infection, malignant effusion, and pneumothoraces. The onus now is on those who favor large tubes to produce clinical data to justify the more invasive approach.

KEYWORDS

Pleural effusion - pneumothorax - empyema - chest drain - intercostal - pleura

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Y. C. Gary LeeM.B.Ch.B. 

University Department of Medicine, 4/F, G Block

QE II Medical Centre, Perth, WA 6009, Australia

Email: gary.lee@uwa.edu.au

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