Comparing Efficacy of Chest Tube Drainage and Needle Aspiration in Pneumothorax Treatment
- Conditions
- Pneumothorax Spontaneous TensionPneumothorax, SpontaneousPneumothorax Spontaneous PrimaryPneumothorax, Recurrent
- Interventions
- Procedure: Chest tube drainageProcedure: Repetitive needle aspiration
- Registration Number
- NCT03293199
- Lead Sponsor
- Tabriz University of Medical Sciences
- Brief Summary
Spontaneous pneumothorax is a common condition which is defined as air presence inside of pleural space. Despite, several studies that have been carried on management patients suffering spontaneous pneumothorax, the first step approach on patients is still the topic of debate. Since chest tube drainage and needle aspiration are widely used first step techniques in spontaneous pneumothorax, current study compares the efficacy of abovementioned techniques, as well as long-term outcomes. In current multi-center single-blinded RCT, all patients admitted with spontaneous pneumothorax will be enrolled study and written consent form provided by patients, simultaneously. Patients randomly assigned to study groups including (A) chest tube drainage and (B) needle aspiration. Subsequently, all patients will undergo one-year follow-up and will be evaluated in terms of treatment success rate and pneumothorax recurrence. Hypothesis of present trial are as follows: a) repetitive needle aspiration may lead to higher treatment success rate in patients with primary spontaneous pneumothorax, in comparison to chest tube drainage, b) needle aspiration may result in reduction of hospital admission duration in patients with primary spontaneous pneumothorax compared to chest tube drainage, c) the rate of spontaneous pneumothorax recurrence during one-year follow up might be lower in patients who undergo needle aspiration instead of chest tube drainage.
- Detailed Description
The chest tube drainage and needle aspiration are widely used first step techniques in spontaneous pneumothorax, thus present randomized controlled trial (RCT) aims to compare the efficacy of abovementioned techniques, as well as long-term outcomes. The study protocol has been confirmed by the ethics committee of AJA University. In current multi-center single-blinded RCT, all patients admitted with primary spontaneous pneumothorax will be enrolled study and written consent form provided by patients, simultaneously. With due attention to the success rate of 18% provided in a previous study comparing primary spontaneous pneumothorax treatment procedures and the study power of 80% and the confidence coefficient of 0.05, study population calculated to include 64 patient, which increased to 70 patients with taking 10% of falling risk into consideration. Using Randlist software, patients will be randomly assigned to study groups including (A) chest tube drainage and (B) needle aspiration. Subsequently, all patients will undergo one-year follow-up and will be evaluated in terms of treatment success rate and pneumothorax recurrence.
In chest tube drainage group, while the patient is positioned in the supine position and subsequent to local anesthesia administration via lidocaine 2%, F16 or F20 (based on patients physical status) sterile plastic tube will be implemented at the level 4th or 5th intercostal space through the midaxillary line. However, in needle aspiration group, patients will be positioned semi-supine. Subsequently, G16 intravenous angiocath will be inserted through the midclavicular line at the level 2nd or 3rd intercostal space. The catheter needle will be removed and catheter will be fixed using sterile sticks. A three-way valve will be connected to the external end of the catheter and a 50 ml syringe will be connected to the valve. The air suction will be performed using 50 ml syringe till end of the air suction or up to 3.5 liters of air suctioning.
Hypothesis of present trial are as follows: a) repetitive needle aspiration may lead to higher treatment success rate in patients with primary spontaneous pneumothorax, in comparison to chest tube drainage, b) needle aspiration may result in reduction of hospital admission duration in patients with primary spontaneous pneumothorax compared to chest tube drainage, c) the rate of spontaneous pneumothorax recurrence during one-year follow-up might be lower in patients who undergo needle aspiration instead of chest tube drainage.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 70
- Aged more than 18 years old
- Symptomatic primary spontaneous pneumothorax or intervention-needed spontaneous pneumothorax (pneumothorax more than 20% in volume due to Light criteria)
- Tension pneumothorax
- bilateral severe respiratory failure
- demand for mechanical ventilation
- bilateral pneumothorax
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Chest tube drainage Chest tube drainage This group will undergo chest tube drainage as an intervention for spontaneous pneumothorax treatment. Needle aspiration Repetitive needle aspiration This group will undergo repetitive needle aspiration as an intervention for spontaneous pneumothorax treatment.
- Primary Outcome Measures
Name Time Method Pneumothorax recurrence during one-year One year postoperative Will be defined as the rate of pneumothorax recurrence until postoperative one-year.
- Secondary Outcome Measures
Name Time Method Length of hospital admission Through hospital admission, an average of 10 days will be calculated from the time of the operation to time of discharge.
Procedure induced complications Postoperative day 1, Postoperative day 3, Postoperative day 7, Postoperative month 1, Includes all complications occurred during or after procedure during hospital stay.
Pneumothorax size Before procedure, 1 hour after procedure, 48 hours after procedure, one-week after procedure Will be calculated by Light's formula using chest radiography
Successful treatment rate Postoperative day 1 and postoperative day 7 Is defined as completely resolved pneumothorax during admission.
Operation time During procedure Will be calculated from the time of skin incision to completing the procedure including complete chest tube insertion in chest tube group or complete air suction or up to 3.5 liters of air suction in needle aspiration group.
Trial Locations
- Locations (1)
Imam Reza hospital
🇮🇷Tabriz, East Azerbaijan, Iran, Islamic Republic of