Do X-rays after chest tube removal change patient management?

Bret Johnson, Michele Rylander, Alana L. Beres

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background A link between childhood radiation and future cancer risks exists, and reduction of unnecessary radiation in childhood has been recommended. Pneumothoraces, pleural effusions, and many surgical procedures require placement of a chest tube/pigtail catheter. Traditional management is daily x-rays, with an x-ray after tube removal. Our hypothesis is the “post pull” x-ray rarely results in changing clinical management of the patient. Methods With IRB approval, a 5-year retrospective chart review was performed. Inclusion criteria were chest tube or pigtail placed for any reason with complete records. Data collected were demographics, reason for and duration of placement, number of x-rays done prior to and after removal. Primary outcome was whether the “post pull” x-ray changed clinical management. Results A total of 179 episodes were evaluated. Seventeen were excluded for incomplete data, or death/transfer of the patient with the tube in situ. Forty-nine tubes/pigtails were placed for pneumothorax, 48 for pleural effusion/empyema, 9 for hemothorax, and 51 during operative procedure. A median of 5 x-rays was done post insertion. 99% of the patients (160/162) had a “post pull” x-ray performed after tube removal. In 9 cases the x-ray changed patient management. Conclusions X-ray after chest tube/pigtail removal rarely changes patient management. We recommend considering imaging if there are clinical symptoms. Level of evidence Prognosis study, level II (retrospective cohort)

Original languageEnglish (US)
Pages (from-to)813-815
Number of pages3
JournalJournal of Pediatric Surgery
Volume52
Issue number5
DOIs
StatePublished - May 1 2017

Fingerprint

Chest Tubes
X-Rays
Pneumothorax
Pleural Effusion
Radiation
Pleural Empyema
Hemothorax
Patient Transfer
Research Ethics Committees
Operative Surgical Procedures
Risk Reduction Behavior
Catheters
Demography

Keywords

  • Chest tube
  • Pigtail
  • Pneumothorax
  • Tube thoracostomy
  • X-ray

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Do X-rays after chest tube removal change patient management? / Johnson, Bret; Rylander, Michele; Beres, Alana L.

In: Journal of Pediatric Surgery, Vol. 52, No. 5, 01.05.2017, p. 813-815.

Research output: Contribution to journalArticle

Johnson, Bret ; Rylander, Michele ; Beres, Alana L. / Do X-rays after chest tube removal change patient management?. In: Journal of Pediatric Surgery. 2017 ; Vol. 52, No. 5. pp. 813-815.
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