Title: Role of ICD in Pleural Diseases
Authors: Niaz Farhat, K.N. Mohan Rao, Nabil Ahmed Salim, Pradeep Ishwarappagol
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.116
Abstract
Study Objective: To evaluate the outcome of Intercostal drainage (ICD) in pleural diseases performed in the department of Respiratory Medicine in Rajarajeswari Medical College and Hospital over a period of one year.
Design: Retrospective.
Patients: All adult patients requiring consultation by a respiratory physician for a ICD.
Results: Data collected over 1year period, 56 patients had undergone intercostal chest drain insertions. Descriptive data are displayed in Table 1.Out of these 31 patients were pneumothorax (55.36%) and 25 ICD insertions were for pleural effusions (44.64%). Average extubation time for ICD in pneumothorax patients is 13.6 days and for pleural effusion patients is 9 days. 10.7% of total pneumothorax cases were primary spontaneous and 89.3% were secondary spontaneous pneumothorax. Majority of pleural effusion cases were tubercular and other causes of effusion were malignancy and empyema.
Conclusions: ICD can be safely performed by pulmonologists with relatively few associated problems. Average extubation time for ICD in pneumothorax cases can be extended to 10-15 days.
Keywords: Intercostal Chest Drain; Pneumothorax; Pleural Effusion.
References
- Nancy A. Collap etal Chest 1997; 112: 709-713
- American Medical Association. Directory of graduate medical programmes, Chicago, American Medical Association 1992-93: 59
- General Medical Council. Consent: patients and doctors making decisions together. London: General Medical Council, 2008.
- Miller KS, Sahn SA. Chest tubes: indications, technique, management and complications. Chest 1987; 91:258-64
- Baumann MH, Strange C, Heffner JE, et al; AACP Pneumothorax Consensus Group. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest 2001;119:590-602.
- MacDuff A,Arnold A et al BTS pleural Disease Guidline Group.2010.Thorax 2010:65(supplement2):ii18-ii31.
- Chee CBE, Abisheganaden J, Yeo JKS, et al. Persistent air-leak in spontaneous pneumothoraxd clinical course and outcome. Respir Med 1998;92:757e61. (3).
- Barker A, Maratos EC, Edmonds L, et al. Recurrence rates of video-assisted thoracoscopic versus open surgery in the prevention of recurrent pneumothorax:a systematic review of randomised and non-randomised trials. Lancet2007; 370:329 e35. (1++).
- Vohra HA, Adamson L, Weeden DF. Does video-assisted thoracoscopic pleurectomy result in better outcomes than open pleurectomy for primaryspontaneous pneumothorax? Int Cardiovasc Thorac Surg 2008;7:673e7. (1++).