Complications after Thoracocentesis and Chest Drain Insertion: A Single Centre Study from the North East of England
Introduction: There are no prospective studies looking at complications of pleural procedures. Previous British Thoracic Society Pleural audits and retrospective case series inform current practice. Incidence of any complication is between 1–15%. We sought to add to the existing literature and infor...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Journal of Respiration |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2673-527X/1/2/14 |
| _version_ | 1797525401824657408 |
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| author | Karl Jackson Opeyemi Kafi Dilraj S. Bhullar Jordan Scott Claire Storey Saara Hyatali Hannah Carlin Andrew Brown Emily Grimshaw Joseph Miller Hannah Rank Sean Porritt Michael Carling Avinash Aujayeb |
| author_facet | Karl Jackson Opeyemi Kafi Dilraj S. Bhullar Jordan Scott Claire Storey Saara Hyatali Hannah Carlin Andrew Brown Emily Grimshaw Joseph Miller Hannah Rank Sean Porritt Michael Carling Avinash Aujayeb |
| author_sort | Karl Jackson |
| collection | DOAJ |
| description | Introduction: There are no prospective studies looking at complications of pleural procedures. Previous British Thoracic Society Pleural audits and retrospective case series inform current practice. Incidence of any complication is between 1–15%. We sought to add to the existing literature and inform local practice with regards to intercostal drains and thoracocenteses. Methods: Local Caldicott approval was sought for a review of all inpatient adult pleural procedures coded as ‘T122 drainage of pleural cavity’ and ‘T124 insertion of tube drain into pleural cavity’. Those undergoing thoracocentesis (all with a Rocket 6 Fg catheter) and intercostal drain insertion (ICD, all with Rocket 12 Fg drain) were identified. Continuous variables are presented as mean (±range) and categorical variables as percentages where appropriate. Results: 1159 procedures were identified. A total of 199 and 960 were done for pneumothorax and effusions respectively. Mean age was 68.1 years (18–97). There were 280 thoracocenteses and 879 ICDs. Bleeding occurred in 6 (0.5%), all ICDs (clotting and platelets were within normal range; one patient was on aspirin and one on aspirin and clopidogrel). All settled except for one who had intercostal artery rupture needing cardiothoracic intervention (no anti-coagulation). Nine pneumothoraces occurred (0.78%) in seven ICDs and two aspirations). There were three definite pleural space infections (0.3%) with three ICDs. Fall out rates for ICDs were 35 (3%). Nine were not sutured, and out of those, seven inserted in the Accident and Emergency department, out of hours. All others ‘came out’ due to patient factors (previous quoted rates up to 14%). Surgical emphysema occurred in 43 (41 ICDs), 3.7%. Eight were due to fall outs and three required surgical intervention. There was no re-expansion pulmonary oedema nor direct deaths. Conclusions: Complication rates of ICD and thoracocenteses are low. Checklists might help to remind operators of the need for suturing. Limitations of this study are its retrospective nature and reliance on correct hospital coding. We are currently contributing to a prospective observational study on pleural complications. |
| first_indexed | 2024-03-10T09:13:16Z |
| format | Article |
| id | doaj.art-b0b09081422541019c75ad488d3caaa3 |
| institution | Directory Open Access Journal |
| issn | 2673-527X |
| language | English |
| last_indexed | 2024-03-10T09:13:16Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Respiration |
| spelling | doaj.art-b0b09081422541019c75ad488d3caaa32023-11-22T05:51:07ZengMDPI AGJournal of Respiration2673-527X2021-05-011213514010.3390/jor1020014Complications after Thoracocentesis and Chest Drain Insertion: A Single Centre Study from the North East of EnglandKarl Jackson0Opeyemi Kafi1Dilraj S. Bhullar2Jordan Scott3Claire Storey4Saara Hyatali5Hannah Carlin6Andrew Brown7Emily Grimshaw8Joseph Miller9Hannah Rank10Sean Porritt11Michael Carling12Avinash Aujayeb13Respiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKRespiratory Department and Northumbria Healthcare NHS Foundation Trust, Cramlington, Northumbeland NE23 6NZ, UKIntroduction: There are no prospective studies looking at complications of pleural procedures. Previous British Thoracic Society Pleural audits and retrospective case series inform current practice. Incidence of any complication is between 1–15%. We sought to add to the existing literature and inform local practice with regards to intercostal drains and thoracocenteses. Methods: Local Caldicott approval was sought for a review of all inpatient adult pleural procedures coded as ‘T122 drainage of pleural cavity’ and ‘T124 insertion of tube drain into pleural cavity’. Those undergoing thoracocentesis (all with a Rocket 6 Fg catheter) and intercostal drain insertion (ICD, all with Rocket 12 Fg drain) were identified. Continuous variables are presented as mean (±range) and categorical variables as percentages where appropriate. Results: 1159 procedures were identified. A total of 199 and 960 were done for pneumothorax and effusions respectively. Mean age was 68.1 years (18–97). There were 280 thoracocenteses and 879 ICDs. Bleeding occurred in 6 (0.5%), all ICDs (clotting and platelets were within normal range; one patient was on aspirin and one on aspirin and clopidogrel). All settled except for one who had intercostal artery rupture needing cardiothoracic intervention (no anti-coagulation). Nine pneumothoraces occurred (0.78%) in seven ICDs and two aspirations). There were three definite pleural space infections (0.3%) with three ICDs. Fall out rates for ICDs were 35 (3%). Nine were not sutured, and out of those, seven inserted in the Accident and Emergency department, out of hours. All others ‘came out’ due to patient factors (previous quoted rates up to 14%). Surgical emphysema occurred in 43 (41 ICDs), 3.7%. Eight were due to fall outs and three required surgical intervention. There was no re-expansion pulmonary oedema nor direct deaths. Conclusions: Complication rates of ICD and thoracocenteses are low. Checklists might help to remind operators of the need for suturing. Limitations of this study are its retrospective nature and reliance on correct hospital coding. We are currently contributing to a prospective observational study on pleural complications.https://www.mdpi.com/2673-527X/1/2/14pleural effusionpneumothoraxintercostal drainthoracocentesis |
| spellingShingle | Karl Jackson Opeyemi Kafi Dilraj S. Bhullar Jordan Scott Claire Storey Saara Hyatali Hannah Carlin Andrew Brown Emily Grimshaw Joseph Miller Hannah Rank Sean Porritt Michael Carling Avinash Aujayeb Complications after Thoracocentesis and Chest Drain Insertion: A Single Centre Study from the North East of England Journal of Respiration pleural effusion pneumothorax intercostal drain thoracocentesis |
| title | Complications after Thoracocentesis and Chest Drain Insertion: A Single Centre Study from the North East of England |
| title_full | Complications after Thoracocentesis and Chest Drain Insertion: A Single Centre Study from the North East of England |
| title_fullStr | Complications after Thoracocentesis and Chest Drain Insertion: A Single Centre Study from the North East of England |
| title_full_unstemmed | Complications after Thoracocentesis and Chest Drain Insertion: A Single Centre Study from the North East of England |
| title_short | Complications after Thoracocentesis and Chest Drain Insertion: A Single Centre Study from the North East of England |
| title_sort | complications after thoracocentesis and chest drain insertion a single centre study from the north east of england |
| topic | pleural effusion pneumothorax intercostal drain thoracocentesis |
| url | https://www.mdpi.com/2673-527X/1/2/14 |
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