Double-Lumen vs Small-Bore Pigtail Catheter for Pleural Effusion: Which is Superior?
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Introduction: Pleural effusion affects approximately 1.3 million people annually, associated with a high mortality rate. Tube thoracostomy remains the standard treatment, with pigtail catheters demonstrating a success rate of 64.0–81.6%. Despite this, double-lumen catheters, typically used for central venous access, are infrequently employed for pleural drainage. This study aims to compare the characteristics of patients undergoing double-lumen catheter versus pigtail catheter placements for pleural effusion.
Methods: A retrospective cross-sectional study was conducted on adult patients at Prof. Chairuddin P. Lubis Hospital, H. Adam Malik General Hospital, and Elizabeth General Hospital in Medan, from September 2022 to April 2024. We analyzed patient demographics and clinical presentations for those receiving either catheter type.
Results: The mean age of patients with double-lumen catheters was 58.21 years, while those with pigtail catheters averaged 54.9 years. Patients with double-lumen catheters frequently presented with a combination of shortness of breath, cough, and chest pain, while those with pigtail catheters primarily reported shortness of breath. Both groups predominantly exhibited exudative pleural effusions. Radiological evaluations indicated that moderate pleural effusion was most common in both groups, with thoracic ultrasound revealing fluid volumes between 500 and 2000 cc.
Conclusion: Double-lumen catheters are more frequently utilized for moderate to massive pleural effusion, whereas pigtail catheters are typically reserved for moderate cases. The choice of catheter depends on the patient's condition, the underlying cause of the effusion, and radiological findings.
Wulandari, S., Syahrani, F., Rahmaini, A. & Eyanoer, PC (2021). Pleural Fluid Leukocyte Levels Test in Establishing Pleural Tuberculosis Effusion in Exudative Pleural Effusion Patients at H. Adam Malik General Hospital Medan in 2018. Indonesian Journal of Respirology, 41, 156-160. [Journal]
Akbar, M. I. (2019). Asuhan Keperawatan Pada Pasien Efusi Pleura dengan Masalah Keperawatan Ketidakefektifan Pola Napas di Ruang Asika RSUD Dr. Harjono Ponorogo. Universitas Muhammadiyah Ponorogo. [Website]
Kulsum, M. F. S. H. A. I. D. (2020). Profil Klinis, Gambaran Makroskopis Dan Mikroskopis Cairan Efusi Pleura Pada Pasien Rawat Inap Di Departemen Ilmu Penyakit Dalam RSUP Dr. Hasan Sadikin Bandung Periode Januari 2016-Desember 2018. Indonesian Journal Chest, 7. [Journal]
Boka, K., (2021). Pleural Effusion [www document]. Drugs Dis. URL https://emedicine.medscape.com/article/299959-overview#a9 (accessed 1.3.24).
Botana Rial, M., Pérez Pallarés, J., Cases Viedma, E., López González, F.J., Porcel, J.M., Rodríguez, M., Romero Romero, B., Valdés Cuadrado, L., Villena Garrido, V., Cordovilla Pérez, R., (2023). Diagnosis and Treatment of Pleural Effusion. Recommendations of the Spanish Society of Pulmonology and Thoracic Surgery. Update 2022. Arch. Bronconeumol. 59, 27–35. https://doi.org/10.1016/j.arbres.2022.09.017 [ScienceDirect]
Jany, B., Welte, T., (2019). Pleural effusion in adults - Etiology, diagnosis, and treatment. Dtsch. Arztebl. Int. 116, 377–386. https://doi.org/10.3238/arztebl.2019.0377 [PubMed]
Shen-Wagner, J., Gamble, C., MacGilvray, P., (2023). Pleural Effusion: Diagnostic Approach in Adults. Am Fam Physician 108, 464–475. [PubMed]
Kolikof, J., Peterson, K., Baker, A.M., (2023). Central Venous Catheter. StatPearls [Internet]. [PubMed]
Zisis, C., Tsirgogianni, K., Lazaridis, G., Lampaki, S., Baka, S., Mpoukovinas, I., Karavasilis, V., Kioumis, I., Pitsiou, G., Katsikogiannis, N., Tsakiridis, K., Rapti, A., Trakada, G., Karapantzos, I., Karapantzou, C., Zissimopoulos, A., Zarogoulidis, K., Zarogoulidis, P., (2015). Chest drainage systems in use. Ann. Transl. Med. 3, 1–9. https://doi.org/10.3978/j.issn.2305-5839.2015.02.09 [Journal]
Bediwy, AS, Amer, H.G., (2012). Pigtail Catheter Use for Draining Pleural Effusions of Various Etiologies. ISRN Pulmonol. 2012, 1–6. https://doi.org/10.5402/2012/143295 [Journal]
Liu, Y.-H., Lin, Y.-C., Liang, S.-J., Tu, C.-Y., Chen, C.-H., Chen, H.-J., … Hsu ,, W.-H. (2010). Ultrasound-guided pigtail catheters for drainage of various pleural diseases. The American Journal of Emergency Medicine, 28(8), 915–921. doi:10.1016/j.ajem.2009.04.041 [PubMed]
Dahlan, M. Sopiyudin. (2014) Statistik untuk Kedokteran dan Kesehatan. Jakarta: Epidemiologi Indonesia [Book]
Ferreiro, L., San José, M.E., Valdés, L., 2015. Management of Parapneumonic Pleural Effusion in Adults. Arch. Bronconemol. 51, 637–646. https://doi.org/10.1016/j.arbr.2015.10.002 [ScienceDirect]
Krishna, R., Antoine, M.H., Rudrappa, M., (2023). Pleural Effusion. StatPearls [Internet]. [PubMed]
Mummadi, S.R., Stoller, J.K., Lopez, R., Kailasam, K., Gillespie, C.T., Hahn, P.Y., (2021). Epidemiology of Adult Pleural Disease in the United States. Chest 160, 1534–1551. https://doi.org/10.1016/j.chest.2021.05.026 [ScienceDirect]
Abdelghany, M.F., Essmat, K., El-Karn, A.F., Youssif, S.F. (2022). Modified indwelling pleural catheter versus silver nitrate pleurodesis for the management of malignant pleural effusion. The Egyptian Journal of Chest Diseases and Tuberculosis. 71, 248-254. [Journal]
El-Shabrawy, M., Elhawary, A. (2019). Preparation for minithoracoscopy by percutaneous pigtail catheter insertion for difficult pleural effusion cases. The Egyptian Journal of Chest Diseases and Tuberculosis. 68, 383-389. [Journal]
Jayakrishnan, B., Kashoob, M., Al-Sukaiti, R., Al-Mubaihsi, S., Kakaria, A., Al-Ghafri, A., Al-Lawati, Y., (2021). Percutaneous ultrasound-guided pigtail catheter for pleural effusions: Efficacy and safety. Oman Med. J. 36, 1–6. https://doi.org/10.5001/omj.2021.19 [PubMed]
Rizana, S.N., Widirahardjo, Soeroso, N.N., & Eyanoer, P.C. (2017). Komplikasi Penggunaan Small Bore Catheter (Kateter pigtail) Dibandingkan Large Bore Cathether untuk Drainase Efusi Pleura. Jurnal Respirologi Indonesia, 37(2), 91–95. [Journal]
Shwaihet, N., Ingram, G., (2014). Use of Double Lumen Central Venous Catheters for the Drainage of Pleural Effusion in Pediatrics. Int. J. Nurs. 2, 1–6. [Journal]
Khare, R., Anand, K., Agrawal, P., Yadav, A., (2022). Comparative analysis of pigtail catheter versus intercostal tube drainage for pleural effusion: a tertiary center study. Int. Surg. J. 10, 105. https://doi.org/10.18203/2349-2902.isj20223600 [Journal]
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