Efficacy and complications of small-bore, wire-guided chest drains

Chest. 2006 Dec;130(6):1857-63. doi: 10.1378/chest.130.6.1857.


Background: Small-bore Seldinger-type chest drains have become increasingly popular in recent years, but there are few data on their effectiveness.

Methods: Data were collected prospectively at the time of drain insertion and continued until drain removal. Patients completed a visual analog score (VAS) of pain on drain insertion.

Results: Fifty-two drains were inserted in 44 patients over 10 months. Drain sizes ranged from 12 to 20F. The mean (+/- SEM) patient age was 64 +/- 2 years, and mean duration of drainage was 4.5 +/- 0.5 days. Fourteen drains (27%) were inserted for pneumothoraces, 19 drains (37%) for malignant effusions, 10 drains (19%) for empyema, 5 drains (10%) for parapneumonic effusions, and 4 drains (8%) for other effusions. Pain VAS ranged from 3 to 66 mm (maximum, 100 mm; average [+/- SD], 23 +/- 16 mm). Although the overall drain failure rate was 37%, there was only one serious complication (empyema), and this compares well with historical control subjects. Success rate was highest when used to treat malignant effusions (83%) and pneumothoraces (64%); drains inserted for empyema were more likely to block (overall success rate, 20%). There was no correlation between the type of fluid or size of drain and likelihood of blockage.

Conclusions: Seldinger-type drains are a well-tolerated and effective method of draining pneumothoraces and uncomplicated effusions. They are more likely to block when draining empyemas but have a comparable failure rate in pneumothorax to large-bore drains.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chest Tubes*
  • Drainage / instrumentation*
  • Empyema, Pleural / etiology
  • Empyema, Pleural / therapy*
  • England
  • Equipment Design
  • Equipment Failure Analysis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Pleural Effusion / etiology
  • Pleural Effusion / therapy*
  • Pneumothorax / etiology
  • Pneumothorax / therapy*
  • Prospective Studies
  • Risk Factors
  • Statistics as Topic
  • Treatment Failure