Chest Tube Insertion: Does Size Matter?

I’m old school. I cut my teeth during the days when there were only two sizes of chest tubes for trauma: big and bigger. That meant 36 French or 40 French. Period. I even went as far as adding a chest tube insertion video to my collection of YouTube posts:

YouTube player

But recently, someone posted a comment on that video to the effect that we are moving away from large chest tubes for trauma.

But are we? Really? Am I missing something? I’ve written a few posts in the last two years, examining some of the newer research on this topic. One paper was so-so, one was terrible.

So I’ve decided to really hit this topic hard this week. I want to know what the literature really says on this topic. So I’ve located the best papers I could and I’m going to do a teardown over the next few days. That way I can make sure that my video is up to date, and that my (and your) practice is as well.

Tomorrow, I’ll start with work that compares large and smaller bore tubes. Through the week, I’ll work my way down in size to papers suggesting that pigtail catheters are as good as a chest tube.

Hope you enjoy! We’ll all learn something!

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