Study of the Length of Needle Thoracostomy Catheter Needed for Patients with Chest Trauma

Kang, Sung Won; Ryoo, Hyun Wook; Park, Jung Bae; Seo, Kang Suk; Chung, Jae Myung

Abstract

PURPOSE
This study was conducted to evaluate the length of the catheter used in a needle thoracostomy for emergency decompression of a tension pneumothorax by measuring the chest wall thickness (CWT) in patients with chest trauma
METHODS
A retrospective review of 201 patients with chest trauma who had been transported the emergency department in a tertiary university hospital in a metropolitan area between 1 January and 31 February 2007 was performed. The average CWT at the second intercostal space (ICS) in the midclavicular line (MCL) was measured by using a chest computed tomography scan.
RESULTS
As the left and the right mean CWTs were 3.4+/-1.0 cm and 3.4+/-1.0 cm, respectively, there was no significant statistical difference between them. The mean CWT of female patients was significantly higher than that of male patients (p=0.001). The mean CWT of patients under the age of 65 years was significantly thicker than that of the patients over the age of 65 years (p<0.001). Of the studied patients, 12 (6.0%) a CWT > 5 cm.
CONCLUSION
A 5 cm-length catheter in a needle thoracostomy may be insufficient for emergency decompression of a tension pneumothorax, so a catheter longer than 5 cm in length is needed.