Journal article
Routine chest X-rays after pigtail chest tube removal rarely change management in children
Pediatric surgery international, v 37(10), pp 1447-1451
01 Oct 2021
PMID: 34173055
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The need for chest X-rays (CXR) following large-bore chest tube removal has been questioned; however, the utility of CXRs following removal of small-bore pigtail chest tubes is unknown. We hypothesized that CXRs obtained following removal of pigtail chest tubes would not change management.
Patients < 18 years old with pigtail chest tubes placed 2014-2019 at a tertiary children's hospital were reviewed. Exclusion criteria were age < 1 month, death or transfer with a chest tube in place, or pigtail chest tube replacement by large-bore chest tube. The primary outcome was chest tube reinsertion.
111 patients underwent 123 pigtail chest tube insertions; 12 patients had bilateral chest tubes. The median age was 5.8 years old. Indications were pneumothorax (n = 53), pleural effusion (n = 54), chylothorax (n = 6), empyema (n = 5), and hemothorax (n = 3). Post-pull CXRs were obtained in 121/123 cases (98.4%). The two children without post-pull CXRs did not require chest tube reinsertion. Two patients required chest tube reinsertion (1.6%), both for re-accumulation of their chylothorax.
Post-pull chest X-rays are done nearly universally following pigtail chest tube removal but rarely change management. Providers should obtain post-pull imaging based on symptoms and underlying diagnosis, with higher suspicion for recurrence in children with chylothorax.
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Details
- Title
- Routine chest X-rays after pigtail chest tube removal rarely change management in children
- Creators
- Christina M Theodorou - University of California Davis Medical CenterMennatalla S Hegazi - University of California Davis Medical CenterHope Nicole Moore - University of California Davis Medical CenterAlana L Beres - University of California Davis Medical Center
- Publication Details
- Pediatric surgery international, v 37(10), pp 1447-1451
- Publisher
- Springer Nature
- Grant note
- UL1 TR001860 / NIH HHS UL1 TR001860 / NCATS NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000667855100001
- Scopus ID
- 2-s2.0-85108793721
- Other Identifier
- 991021969585704721
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- Web of Science research areas
- Pediatrics
- Surgery