Open Access

Should central venous catheters be used to drain pleural effusions?

Critical Care20048:56

https://doi.org/10.1186/cc2447

Published: 2 January 2004

We read with interest the article by Singh and coworkers [1] describing the use of central venous catheters to drain pleural effusions.

We agree that the use of small-bore catheters has a number of advantages compared with repeated thoracocentesis or the use of traditional large-bore drains inserted by blunt dissection. Indeed, recent guidelines [2] support the use of smaller bore tubes (8–14 Fr; except for haemothorax) in both pleural effusions and pneumothorax.

However, we have reservations regarding the routine use of central venous catheters to drain pleural effusions. Several manufacturers (including the Sims-Portex Seldinger Chest Drainage Kit and Cook Quick-Thal Chest Tube) have specific chest drainage systems that take advantage of the Seldinger dilator over a wire method of insertion. These have the advantage of having a number of side ports (two to four), which reduces the possibility of blockage by debris, and they are available in a range of sizes (8–36 Fr).

While we applaud innovation, in today's medico-legal climate it is surely wiser to use specifically designed equipment if it is available.

Authors’ Affiliations

(1)
Locum Registrar Respiratory Medicine, Western General Hospital
(2)
Consultant Intensive Care Medicine, Western General Hospital

References

  1. Singh K, Loo S, Bellom R: Pleural drainage using central venous catheters. Crit Care 2003, 7: R191-R194. 10.1186/cc2393PubMedPubMed CentralView ArticleGoogle Scholar
  2. Laws D, Neville E, Duffy J, on behalf of the British Thoracic Society Pleural Disease Group: BTS guidelines on the insertion of a chest drain. Thorax 2003, Suppl II: ii53-ii59.View ArticleGoogle Scholar

Copyright

© BioMed Central Ltd 2004

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