What size of chest tube would you use in the management of trauma related pneumothorax?

Although most guidelines for chest trauma recommend a large-bore chest tube, e.g., the 9th edition of the ATLSTM (Advanced Trauma Life Support) program recommends a 36 or 40 Fr tube,1 and the JATECTM (Japan Advanced Trauma Evaluation and Care) course recommends a 28 Fr or larger tube and choosing the tube size based on …

What are chest tube sizes?

Chest tubes are made in a range of sizes measured by their external diameter from 6 Fr to 40 Fr. Chest tubes, like most catheters, are measured in French catheter scale. For adults, 20 Fr to 40 Fr (6.7 to 13.3mm external diameter) are commonly used, and 6 Fr to 26 Fr for children.

What size of chest drain is usually used?

Chest drains come in a range of sizes suitable for a variety of purposes (typically 10-36Ch) and may be inserted via an open surgical incision (thoracostomy) or using the Seldinger technique incorporating a guide wire and dilator system.

When do you use a hemothorax chest tube?

This is usually performed within 7-8 days of the initial injury and, in some centers, is performed within 48-72 hours if a retained clot is identified within the thorax. However, VATS may be successful even in patients presenting late after injury.

Does Size Matter chest tube?

Conclusions: For injured patients with chest trauma, chest tube size did not impact the clinically relevant outcomes tested. There was no difference in the efficacy of drainage, rate of complications including retained hemothorax, need for additional tube drainage, or invasive procedures.

What size hemothorax needs a chest tube?

Generally, large- bore chest tubes (32–40 Fr) are used for the treatment of traumatic pneumothorax and hemothorax. Traditionally, a tube with a large diameter has been the standard, as both air and blood are thought to be better removed from the pleural cavity with the large tube.

How big is a pneumothorax?

Under the new guidelines, the size of a pneumothorax is divided into “small” or “large” depending on the presence of a visible rim of <2 cm or ⩾2 cm between the lung margin and the chest wall. The authors then explained in detail how these distances could be used to estimate the percentage of lung collapse.

How do you measure a chest tube?

Measure the length between the skin incision and the apex of the lung to estimate how far the chest tube should be inserted. If desired, place a clamp over the tube to mark the estimated length. Some prefer to clamp the tube at a distal point, memorizing the estimated length.

What is a pigtail chest tube?

Small-bore chest tubes – also referred to as pigtail catheters – are being used to relieve both spontaneous and in some cases, traumatic pneumothorax. These pigtails are placed with a Seldinger catheter-over-wire technique very similar to the central venous catheter insertion.

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