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Complications of percutaneous thoracostomy in neonates and infants

Abstract

Objective:

Percutaneous thoracostomy tubes are widely used in neonates, infants and children. The technique has a low complication rate. Lung perforation by a pigtail catheter is described in a single case report.

Study Design:

This is a multi-center case series of neonates and infants who experienced thoracic organ injury following percutaneous chest tube placement between 2006 and 2015.

Result:

Eleven patients had chest tube-related thoracic organ injury. In six, tubes were placed during resuscitation. Gestational ages ranged from 24+6 weeks to term. Most of the chest tubes were pigtail catheters, and the most common injury was lung lobe perforation. Pericardium and mediastinum were also sites of injury. Some patients had small pleural effusions, with no other complications identified.

Conclusion:

Thoracic organ injury by percutaneous catheters may be more common than previously appreciated. Clinical and radiological findings are non-specific, and the diagnosis may not be apparent until autopsy.

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References

  1. Wilson AJ, Krous HF . Lung perforation during chest tube placement in the stiff lung syndrome. J Pediatr Surg 1974; 9: 213–216.

    Article  CAS  Google Scholar 

  2. Moessinger AC, Driscoll JM, Wigger HJ . High incidence of lung perforation by chest tube in neonatal pneumothorax. J Pediatr 1978; 92: 635–637.

    Article  CAS  Google Scholar 

  3. Fuhrman BP, Landrum BG, Ferrara TB, Steinhorn DM, Connell AP, Smith-Wright LD et al. Pleural drainage using modified pigtail catheter. Crit Care Med 1986; 14: 575–576.

    Article  CAS  Google Scholar 

  4. Hwang MS, Chu JJ, Su WJ . Diaphragmatic paralysis caused by malposition of chest tube placement after pediatric cardiac surgery. Int J Cardiol 2005; 99: 129–131.

    Article  Google Scholar 

  5. Nahum E, Ben-Ari J, Schonfeld T, Horev G . Acute diaphragmatic paralysis caused by chest-tube trauma to phrenic nerve. Pediatr Radiol 2001; 31: 444–446.

    Article  CAS  Google Scholar 

  6. Marinelli PV, Ortiz A, Alden ER . Acquired eventration of the diaphragm: a complication of chest tube placement in neonatal pneumothorax. Pediatrics 1981; 67: 552–554.

    CAS  PubMed  Google Scholar 

  7. Thomas DT, Dagli TE, Kiyan G . Horner's syndrome as a rare complication of tube thoracostomy: case reports and review of literature. J Pediatr Surg 2013; 48: 1429–1433.

    Article  Google Scholar 

  8. Miller KS, Sahn SA . Chest tubes: indications, technique, management and complications. Chest 1987; 91: 258–264.

    Article  CAS  Google Scholar 

  9. Iberti TJ, Stern PM . Chest tube thoracostomy. Crit Care Clin 1992; 8: 879–895.

    Article  CAS  Google Scholar 

  10. Roberts JS, Bratton SL, Brogan TV . Efficacy and complications of percutaneous pigtail catheters for thoracostomy in pediatric patients. Chest 1998; 114: 1116–1121.

    Article  CAS  Google Scholar 

  11. Brooker RW, Booth GR, DeMello DE, Keenan WJ . Unsuspected transection of lung by pigtail catheter in a premature infant. J Perinatol 2007; 27: 190–192.

    Article  CAS  Google Scholar 

Download references

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Correspondence to R C Reed.

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Reed, R., Waters, B. & Siebert, J. Complications of percutaneous thoracostomy in neonates and infants. J Perinatol 36, 296–299 (2016). https://doi.org/10.1038/jp.2015.190

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  • DOI: https://doi.org/10.1038/jp.2015.190

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