Negotiation-Based Therapeutic Analysis

Introduction The 14-French (F) pigtail catheters (PCs) are small-caliber catheters that are percutaneously placed at bedside, in comparison with the tradition large-caliber (32-40F) chest tubes (CTs) that are placed by an open cut-down technique 1-3. The PC’s roles and its effectiveness in the management of trauma patients with pneumothorax 3 and hemothorax (HTX)/hemopneumothorax (HPTX) 4 have previously been published. It is controversial and many clinicians still question whether or not blood in the chest cavity can be effectively drained by such a small caliber PC and whether or not one always needs the larger-caliber CTs to properly drain the blood 5-6. The benefits of the PCs and the argument for their use are that it is placed percutaneously with a small skin incision, it is
Table 1 summarized the generalized characteristics and outcomes comparing overall PCs and the traditional CTs. Despite the similar or non-inferior outcomes in our primary outcome of interest (initial output, insertion-related complication, and failure rate), we still selectively placed PCs in blunt and older trauma patients, and whose tubes were placed in a delayed and non-urgent situation, day tube-inserted, PCs, day 1 [interquartile range (IQR): 1-3 days] vs. CTs, day 0 [IQR: 0-1 days], P <0.001. However, as our comfort level and experience in PC usage continued to grow, placing PCs under more urgent situation continued to increase (Table 3, urgent vs. Table 2, non-urgent comparison). Initial output, insertion-related complications, and failure remained unaffected by the 14F PCs placed under urgent situation (Table 3). Table 4 provided a description of tube-insertion related complications. Overall incidence was similar between PCs and CTs. Most of our PC technical failures occurred early on during the period when we were still on a learning