Does tube size matter?

Download presentation here:

Tube Thoracostomy TREAT

Our inaugural TREAT looked at the evidence behind chest drain size.  Historically a large drain is advocated for traumatic pneumothorax and haemothorax, or combination thereof, but is there any evidence this is better than smaller tubes?

Points to note:

The French system refers to external diameter and not internal diameter

There is no evidence supporting large drains, it’s a historical legacy

There is no good evidence that smaller drains produce better volume drainage, shorter duration, or reduced pain.

May worth thinking about smaller drains, or Seldinger technique, if just pneumothorax.

 

Links & references:

StEmlyns

BestBETS

Inaba paper

Tanizaki paper

Kulvatunyou paper

Yi paper

Hardy paper

Russo paper

 

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