1674 EFFECTIVENESS OF CHEST TUBE PLACEMENT IN THE NEONATE

Success of chest tube placement for evacuation of a pneumothorax from two thoracostomy approaches was compared, Superior (1-3rd ICS MCL) vs. Lateral (4-6 ICS AAL). Effectiveness, as it

related to the tube tip position in the chest, was also compared, anterior vs. posterior. A retrospective review was conducted of all NICU admissions in 1979. Fifty-seven neonates had 91

pneumothoraces for which 119 chest tubes were placed.

Chest tubes evacuated a pneumothorax significantly more often if the tube lay anterior to the lung vs. posterior, 45/47 (96%) vs. 17/40 (42%) respectively. The superior insertion route

resulted in significantly more anterior tubes than the lateral insertion 35/41 (85%) vs. 33/74 (47%) respectively. Superior anterior tubes were virtually as effective as lateral anterior

tubes, 21/23 vs. 24/24 respectively. Complications included a 10% encroachment of superior tubes on the mediastinum vs. 32% for lateral tubes. Other complications occurred predominantly with

lateral tubes. We conclude pneumothoraces were more effectively evacuated with anterior position of the chest tube tip. The lateral thoracostomy approach resulted in more posterior tubes

and more complications. The superior insertion site seems an acceptable alternative to, if not better than, the traditional lateral insertion site, for evacuation of neonatal pneumothoraces.

Anyone you share the following link with will be able to read this content: