ArticleThe journal of trauma and acute care surgery2025
Percutaneous pigtail catheter versus chest tube for the treatment of pediatric traumatic hemothorax: An Eastern Association for the Surgery of Trauma multicenter study.
Laura F Goodman, Alice M Martino, John Schomberg, Jason D Sciarretta, Mari Freedberg, Adora Santos, Sharven Taghavi, Martin Tafazoli, David V Shatz, Kathleen E Doyle and 71 more
Article in The journal of trauma and acute care surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Laura F GoodmanFrom the Department of Surgery (L.F.G., A.M.M.), University of California Irvine, Irvine; Division of Pediatric Surgery (L.F.G.), Department of Nursing (J.S.), and CHOC Research Institute (J.S.), Children's Hospital of Orange County, Orange, California; Division of Acute Care Surgery, Department of Surgery (J.D.S., M.F., A.S.), Grady Memorial Hospital, Emory University School of Medicine, Atlanta, Georgia; Department of Surgery (S.T., M.T.), Tulane University, New Orleans, Louisiana; Division of Trauma, Acute Care Surgery, and Surgical Care (D.V.S.), and Department of Surgery (K.E.D.), University of California Davis Medical Center, Sacramento, California; Division of Pediatric Surgery (S.M.K., R.T.R.), Children's of Atlanta, Birmingham, Alabama; Department of Trauma Surgery (V.C.S., S.W.R.), Atrium Health Carolinas Medical Center, Charlotte, North Carolina; Division of Pediatric Surgery (L.W., R.F.W.), Le Bonheur Children's Hospital, Memphis, Tennessee; Division of Pediatric General and Thoracic Surgery (M.K., S.J.H.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Pediatric Surgery (D.W., D.K.), University of Arkansas for Medical Sciences, Little Rock, Arkansas; Dewitt Department of Surgery (N.N., C.S.), Jackson Memorial Hospital, Miami, Florida; Division of Pediatric Surgery (R.S., M.L.O.), Children's Hospital Los Angeles, Los Angeles, California; Department of Surgery (R.S.C., D.N.N.), Mayo Clinic Arizona, Phoenix, Arizona; Division of Acute Care Surgery, Department of Surgery (A.G.M.), Kirk Kerkorian School of Medicine at UNLV, Las Vegas, Nevada; Department of Surgery (M.F., E.H.), Lehigh Valley Health Network, Allentown, Pennsylvania; Department of Surgery (A.B.F.), Division of Pediatric Surgery (C.J.S.), Medical University of South Carolina, Charleston, South Carolina; Division of Trauma and Acute Care Surgery (R.G.-C., A.D.), SUNY Upstate Medical University, Syracuse, New York; Division of Trauma, Department of Surgery (I.A.), Cooper University Hospital, Camden, New Jersey; Department of Surgery (S.P.G., M.J.M.), University of Southern California Keck School of Medicine, Los Angeles, California; Pediatric Surgery (O.B.L., K.P.), Joe DiMaggio Children's Hospital, Hollywood, Florida; Surgical and Trauma Services (T.K.D., G.D.), Ventura County Medical Center, Ventura; Division of Pediatric Surgery, Department of Surgery (S.D.C., M.E.P.), Stanford School of Medicine, Palo Alto, California; Division of Pediatric Surgery, Department of Surgery (D.D., M.B.), University of Rochester Medical Center, Rochester, New York; Department of Surgery (F.M., V.M.), General University Hospital of Patras, Patras, Greece; Division of Pediatric Surgery (A.A., R.G.), Dayton Children's Hospital, Wright State University, Dayton, Ohio; Trauma Division, Surgery Department (D.C.C., C.G.T.), Maine Medical Center, Portland, Maine; Division of Trauma, Burns, Critical Care, and Acute Care Surgery (C.A., J.N.), University of California Irvine, Orange; Comparative Effectiveness and Clinical Outcomes Research Center (S.B.E., R.C.), Riverside University Health System, Moreno Valley, California; Department of Pediatric Surgery (L.P.N., J.L.R.), Atrium Health Wake Forest, Winston-Salem, North Carolina; Division of Trauma/Acute Care Surgery/Surgical Critical Care (J.A.K., H.K.E.K.), Harbor-UCLA Medical Center, Torrance, California; Trauma Services (C.F., P.P.), Sunrise Hospital and Medical Center; Department of General Surgery (C.F., P.P.), Sunrise Health GME Consortium, HCA Healthcare, Las Vegas, Nevada; Department of Surgery (V.S., C.L.), Jersey Shore University Medical Center, Neptune, New Jersey; Department of General Surgery (U.P.), Naval Medical Center San Diego; Division of Pediatric Surgery, Department of Surgery (R.C.I.), Rady Children's Hospital San Diego, University of California San Diego School of Medicine, San Diego; Department of Pediatric Surgery (A.R., G.M.), Loma Linda University, Loma Linda, California; Pediatric Surgery (P.C.B., D.W.R.), WVU Medicine Children's, Morgantown, West Virginia; Department of Pediatric Surgery (P.E.L., S.T.-M.), Nicklaus Children's Hospital, Miami, Florida; Department of Pediatric General, Thoracic, and Minimally Invasive Surgery (A.B., S.P.), St. Christopher's Hospital for Children, Philadelphia, Pennsylvania; Trauma and Acute Care Surgery (A.C.), Surgical Critical Care, Legacy Emanuel Hospital, Portland, Oregon; Department of Surgery (S.D.B., A.U.), University of Tennessee-Chattanooga, Chattanooga, Tennessee; Department of Surgery (B.M.H., S.L.C.), Valley Children's Hospital, Madera; Department of Surgery (U.F.B.), Cedars-Siani Medical Center, Los Angeles, California; R. Adams Cowley Shock Trauma Center (E.J.L.), University of Maryland, Baltimore, Maryland; Section of Pediatric Surgery, Department of Surgery (P.E., N.S.), University of Michigan School of Medicine, Ann Arbor, Michigan.ORCID 0000-0002-2340-8311
backgroundSmall percutaneously placed pigtail catheters (PCs) for traumatic hemothorax (HTX) are safe and effective in adults but have not been evaluated in children. We hypothesized that PC would have similar efficacy and complication rates compared with chest tubes (CTs).
methodsA retrospective study of hemodynamically stable pediatric trauma patients (younger than 18 years) with HTX or hemopneumothorax was conducted at 41 trauma centers (January 2010 to December 2022). Catheter failure was defined as a requirement for surgery, additional tube placement, or thrombolytics. Multivariable logistic regression analysis adjusting for age, sex, mechanism of injury, and Injury Severity Score (ISS) was used to evaluate the associated risk of failure.
resultsOf 548 patients, 477 had CT and 71 PC. The median age (CT: 15.7 vs. PC: 15.6, p = 0.49) and ISS (CT: 17 vs. PC: 16, p = 0.17) were similar between cohorts. Penetrating trauma patients more often received CTs (62.6% vs. 35.2%, p < 0.0001). Failure rate was similar between CT versus PC (17.6% vs. 12.6%, p = 0.38). While the overall complication rate (respiratory distress, effusion, empyema, pneumonia, infection, deep venous thrombosis) was higher in the PC group on univariate analysis (19.7% vs. 11.9% in CT, p = 0.02), the risk of complications was not increased on multivariable analysis (odds ratio, 1.05; 95% confidence interval, 0.95-1.15; p = 0.3). Length of stay and intensive care unit length of stay were similar between cohorts (all p > 0.05). Logistic regression analysis revealed that PC was not associated with the risk of failure (odds ratio, 0.95; 95% confidence interval, 0.87-1.04; p = 0.31). There was an increased risk of complications with ISS of >15 (odds ratio, 1.17; 95% confidence interval, 1.10-1.26; p < 0.0001) and lower risk with penetrating injury (odds ratio, 0.86; 95%confidence interval, 0.80-0.92; p = 0.0001).
conclusionThere was no difference in risk of failure between PC and CT for pediatric HTX/hemopneumothorax and no difference in risk of complications after adjustment for confounders. Pigtail catheters had similar safety and efficacy compared with larger-bore CTs in this large multi-institutional study. LEVEL OF EVIDENCE: Therapeutic/Care Management; Level IV.
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Percutaneous pigtail catheter versus chest tube for the treatment of pediatric traumatic hemothorax: An Eastern Association for the Surgery of Trauma multicenter study. · full record | OpenQuestion