Disorders of the Pleura |

Efficacy and Complication Rates of Percutaneous Small-Bore Tube Thoracostomy in Obese vs Nonobese Cohort FREE TO VIEW

Parth Rali, MD; Raghukumar Thirumala; Josebelo Chong; Marvin Balaan
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Allegheny General Hospital, Pittsburgh, PA

Chest. 2014;146(4_MeetingAbstracts):435A. doi:10.1378/chest.1992507
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SESSION TITLE: Pleural Disease Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Percutaneous small-bore (<14 Fr) tube thoracostomy are increasingly used when compared to large-bore/surgical (>28 Fr) tube thoracostomy for the management of pleural effusions and pneumothorax. Even with ultrasound guidance, placing small-bore chest tube can be a challenging task in obese patients. Little is known about the complication rate in this population

METHODS: We performed a retrospective chart review of 43 patients who underwent small-bore tube thoracostomy in a tertiary care teaching hospital between Sept - Dec 2013. All procedures were performed in the Medical Intensive Care Unit (MICU) or medical floors using small bore tube thoracostomy (8 Fr/10Fr/12 Fr). The majority of the procedures were performed by pulmonary fellows and medicine residents using ultrasound guidance and expert faculty supervision. We collected data on age, sex, race, BMI, indication, site, characteristics of the pleural fluid, coagulation parameters, need for blood products and procedure related complication like bleeding, malpositioning or pneumothorax. We categorized patients with a BMI >30 as obese and BMI <30 as non-obese. Data is presented as mean (±SD), percentages and the statistical analysis were performed using student t-test.

RESULTS: Out of 43 patients, 16(38%) were obese and 27(62%) were non-obese. Mean BMI in obese group was 37.4 vs. 24 in non- obese group (p<0.001). There were no significant pre-procedure difference in the use of plavix (p=0.16), platelet count (p=0.25), platelet transfusions (p=0.73), INR (p=0.52) or FFP transfusion (p=0.73) between the two groups. There were no significant procedure related complications like bleeding, pneumothorax or clogging noted in obese or non-obese group (p = 0.56).

CONCLUSIONS: Based on our data analysis, small-bore tube thoracostomy have no increased complication rate in obese individuals compared to non-obese individuals.

CLINICAL IMPLICATIONS: Small-bore tube thoracostomy can be safely and effectively placed under ultrasound guidance and expert supervision in obese patients

DISCLOSURE: The following authors have nothing to disclose: Parth Rali, Raghukumar Thirumala, Josebelo Chong, Marvin Balaan

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