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Assessment of Pleural Effusion and Small Pleural Drain Insertion by Resident Doctors in an Intensive Care Unit: An Observational Study.
- Source :
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Clinical medicine insights. Circulatory, respiratory and pulmonary medicine [Clin Med Insights Circ Respir Pulm Med] 2019 Sep 03; Vol. 13, pp. 1179548419871527. Date of Electronic Publication: 2019 Sep 03 (Print Publication: 2019). - Publication Year :
- 2019
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Abstract
- Small-bore pleural drainage device insertion has become a first-line therapy for the treatment of pleural effusions (PLEFF) in the intensive care unit; however, no data are available regarding the performance of resident doctors in the execution of this procedure. Our aim was to assess the prevalence of complications related to ultrasound-guided percutaneous small-bore pleural drain insertion by resident doctors. In this single-center observational study, the primary outcome was the occurrence of complications. Secondary outcomes studied were as follows: estimation of PLEFF size by ultrasound and postprocedure changes in PaO <subscript>2</subscript> /FiO <subscript>2</subscript> ratio. In all, 87 pleural drains were inserted in 88 attempts. Of these, 16 were positioned by the senior intensivist following a failed attempt by the resident, giving a total of 71 successful placements performed by residents. In 13 cases (14.8%), difficulties were encountered in advancing the catheter over the guidewire. In 16 cases (18.4%), the drain was positioned by a senior intensivist after a failed attempt by a resident. In 8 cases (9.2%), the final chest X-ray revealed a kink in the catheter. A pneumothorax was identified in 21.8% of cases with a mean size (±SD) of just 10 mm (±6; maximum size: 20 mm). The mean size of PLEFF was 57.4 mm (±19.9), corresponding to 1148 mL (±430) according to Balik's formula. Ultrasound-guided placement of a small-bore pleural drain by resident doctors is a safe procedure, although it is associated with a rather high incidence of irrelevant pneumothoraces.<br />Competing Interests: Declaration of Conflicting Interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Details
- Language :
- English
- ISSN :
- 1179-5484
- Volume :
- 13
- Database :
- MEDLINE
- Journal :
- Clinical medicine insights. Circulatory, respiratory and pulmonary medicine
- Publication Type :
- Academic Journal
- Accession number :
- 31516312
- Full Text :
- https://doi.org/10.1177/1179548419871527