Template:Chest tube size table: Difference between revisions

Latest revision as of 12:11, 18 July 2020

Chest Tube Size	Type of Patient	Underlying Causes
Small (8-14 Fr)	Most spontaneous pneumothorax (primary and secondary) Most iatrogenic pneumothorax	Alveolar-pleural fistulae (small air leak) Iatrogenic air
Medium (20-28 Fr)	Traumatic pneumothorax Traumatic hemothorax ("any acute hemothorax visible on chest radiograph")^[1]^[2] Pneumothorax on mechanical ventilation Non-traumatic tension pneumothorax Malignant effusion	Trauma/bleeding (hemothorax/hemopneumothorax) Bronchial-pleural fistulae (large air leak) Malignant fluid
Large (36-40 Fr)	Empyema	Thick pus

@@ Line 13: / Line 13: @@
 |-
 | Medium (20-28 Fr)||
-*Pneumothorax on mechanical ventilation
+*[[Traumatic pneumothorax]]
+*Traumatic [[hemothorax]] ("any acute [[hemothorax]] visible on chest radiograph")<ref>Inaba Et. al J [https://www.ncbi.nlm.nih.gov/pubmed/22327984 Trauma Acute Care Surg. 2012 Feb;72(2):422-7.]</ref><ref>[https://www.ncbi.nlm.nih.gov/pubmed/30711226 Advanced Trauma Life Support® Update 2019: Management and Applications for Adults and Special Populations.]</ref>
+*[[Pneumothorax]] on mechanical ventilation
 *Non-traumatic [[tension pneumothorax]]
 *Malignant effusion
 ||
+*Trauma/bleeding (hemothorax/hemopneumothorax)
 *Bronchial-pleural fistulae (large air leak)
 *Malignant fluid
 |-
 | Large (36-40 Fr)||
-*[[Traumatic pneumothorax]]
-**2012 study using  28-32 Fr tube just as good as 36-40 Fr tube. <ref>Inaba Et. al J [https://www.ncbi.nlm.nih.gov/pubmed/22327984 Trauma Acute Care Surg. 2012 Feb;72(2):422-7.]</ref> This is reflected in the ATLS 2019 Guidelines: "ATLS ® -10 now recommends placement of a smaller 28F to 32F chest tube for any acute hemothorax that is visible on chest radiograph." <ref>[https://www.ncbi.nlm.nih.gov/pubmed/30711226 Advanced Trauma Life Support® Update 2019: Management and Applications for Adults and Special Populations.]</ref>
 *[[Empyema]]
 ||
-*Bleeding (Hemothorax/hemopneumothorax)
 *Thick pus
 |}