Management of Pleural Effusion Using Small-bore Catheter in Intensive Care Unit

분야: 의약학 > 내과학
저자: 이지호 , 유태선 , 김현식 , 김종환 , 이명규 , 용석중 , 신계철 , 리원연
발행기관: 대한결핵 및 호흡기학회
간행물정보: 대한결핵및호흡기학회 추계학술발표초록집 2012년, 제114권 263(총1페이지)
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연관 논문

Risk Factors of Central Venous Catheter Leakage in Neonatal Intensive Care Unit

PE-110 : A case of pleural extravasation of total parenteral nutrition due to central venous catheter( CVC) migration

PE-134 : Four or more urokinase instillations may be required for better clinical outcomes in patients with complicated pleural effusion

종설 : 호흡기내과 의사를 위한 Respiratory Review of 2010

원저 : 호흡이 곤란한 응급 환자에게 시행한 ED-BLUE (Emergency department-Bedside Lung Ultrasound in Emergency) protocol의 유용성

영문초록

Introduction: Pleural effusions (PE) are common in critically ill patients managing in intensive care unit (ICU). Recently, various SBCs have been tried to drain PE over chest tube (CT) thoracostomy, because pleural drainage with SBC is less invasive and has less severe complications. Methods: We reviewed medical records of the adult patients who were admitted in the ICUs and selected the patients underwent drainage for PEs. PEs drained with SBCs (7F single lumen central venous catheters) or CT thoracostomy (＞28F). We compared patient characteristics, effectiveness and complications of drainage methods. Results: One hundred sixty one were drained with SBC in 113 patients and 37 were drained with CT in 22 patients. Bilateral drainages were 22/113 (19.5%) and 8/22 (36.4%) in SBC and CT group. In SBC group, there were more patients of transudate (62.2% vs. 31.8%; p=0.016) and heart failure (27.6% Vs 0.5%; p=0.024). In CT group, there were more patients of empyema (2.0% vs. 13.6%; p=0.042) and hemothorax (2.0% Vs. 22.7%; p=0.002). Mean duration of drainage was 8.5±8.7 and 11.4±6.9 days in SBC and CT group (p=0.143). Complication occurred in 8 patients (7%) and 2 patients (9%) in SBC CT group (p=0.103). All 8 in SBC were pneumothorax, 3 was replaced with CT who showed no improvement of pneumothorax. In CT group, catheter infection and subcutaneous emphysema occurred during PE drainage. Conclusions: The use of an indwelling 7F central venous catheter was as efficacious as CT in draining PEs in ICU. It may be helpful to avoid repeated thoracentesis or the use of CT.

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