ArticleLife (Basel, Switzerland)2026
Pleural Effusion Phenotype and Ultrasound Guidance Approach Associated with Unplanned Pigtail Pleural Catheter Removal in an Adult Intensive Care Unit: A Single-Center Retrospective Cohort Study.
Article in Life (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
backgroundPleural pigtail catheters are widely used in intensive care units (ICUs), but factors associated with unplanned removal remain incompletely characterized.
methodsWe conducted a single-center retrospective cohort study of adult ICU catheter-placement episodes from December 2020 to March 2025. Effusions were grouped as complex (exudative, empyema, malignant, or malignancy-related) or simple (transudative or hemothorax). The primary outcome was unplanned removal for a catheter-related complication or escalation to surgery. Associations were evaluated using Firth penalized logistic regression.
resultsAmong 175 screened episodes, 140 were analyzed; unplanned removal occurred in 12 (8.6%). Complex effusions (adjusted odds ratio [aOR] 6.50, 95% confidence interval [CI] 1.59-26.55) and ultrasound-assisted insertion (aOR 10.72, 95% CI 1.92-59.94) were associated with higher odds of unplanned removal. Reclassifying hemothorax as complex attenuated but did not reverse the phenotype association (aOR 4.84, 95% CI 1.17-19.93). The ultrasound association may reflect case selection, operator workflow, or procedural complexity rather than causality. Because 33 death-related episodes were excluded, the 8.6% rate applies to episodes with classifiable non-death endpoints, not all screened episodes.
conclusionsThese findings are hypothesis-generating and insufficient to change clinical practice without prospective multicenter validation.
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