Pigtail Catheter and Discharge for Patients with Large Pneumothoraces

Traditional tube thoracostomy is invasive, can be painful, and requires inpatient care. Some centers manage small pneumothoraces with pigtail catheters and Heimlich valves on an outpatient basis. Investigators from a French hospital evaluated outcomes when this approach was used to treat large pneumothoraces.

Pigtail catheters were placed anteriorly in the mid-clavicular line at the second or third intercostal space, with local anesthesia. Of 132 patients, 103 (78%) were managed as outpatients. The rest were hospitalized either initially or on day 4 for catheter suction when the pneumothorax failed to improve.