Comparison of a large and small-calibre tube drain for managing spontaneous pneumothoraces

Respir Med. 2009 Oct;103(10):1436-40. doi: 10.1016/j.rmed.2009.04.022. Epub 2009 Jun 7.


To compare treatment success of large- and small-bore chest drains in the treatment of spontaneous pneumothoraces the case-notes were reviewed of those admitted to our hospital with a total of 73 pneumothoraces and who were treated by trainee doctors of varying experience. Both a large- and a small-bore intercostal tube drain system were in use during the two-year period reviewed. Similar pneumothorax profile and numbers treated with both drains were recorded, resulting in a similar drain time and numbers of successful and failed re-expansion of pneumothoraces. Successful pneumothorax resolution was the same for both drain types and the negligible tube drain complications observed with the small-bore drain reflected previously reported experiences. However the large-bore drain was associated with a high complication rate (32%) with more infectious complications (24%). The small-bore drain was prone to displacement (21%). There was generally no evidence of an increased failure and morbidity, reflecting poorer expertise, in the non-specialist trainees managing the pneumothoraces. A practical finding however was that in those large pneumothoraces where re-expansion failed, the tip of the drain had not been sited at the apex of the pleural cavity irrespective of the drain type inserted.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Catheterization / adverse effects
  • Catheterization / instrumentation*
  • Chest Tubes / adverse effects
  • Clinical Competence
  • Drainage / adverse effects
  • Drainage / instrumentation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pneumothorax / therapy*
  • Risk Factors
  • Treatment Outcome
  • Young Adult