Comparison of small lumen versus large lumen inter costal catheter drainage in empyema thoracis on degree of comfort and re-expansion of lungs: An open label, quasi randomized study

Abstract

Background: Use of intercostal drainage tube (ICDT) is an accepted treatment of empyema thoracis (ET).We compared the effectiveness of small versus large lumen ICDT on degree of pain on 4th day of ICDT insertion as well as drainage of pus in cases of ET. Methods: It was an open labelled quasi randomized study, conducted in a tertiary care Hospital of Northern India. Children 2 month to 12 year old were randomized by days of the week into two groups. In group A, 12/14F and in group B, <14F ICDT was used (1,2,12).Face, Legs, Activity, Cry, Consolability (FLACC) pain scoring was used on 4th day of ICDT insertion. Ultrasound (USG) of thorax was done on day1,between day 5-6 and 10-12 to assess the amount of fluid. Results: From September 2018 to August 2019,130 cases (66 in group A and 64 in group B) were enrolled. FLACC Pain score was higher in group B (7.50±1.272) as compared to group A (2.86 ± 0.839) (p = 0.034).there was no significant difference in amount of fluid drained between day1and 5 in group A versus group B (159.3 ml ±125.9 ml versus 179.5 ml ±167.6 ml, p=0.2) and between day 1 & 10 (205.6 ml ± 130.2 ml versus 244.5 ml ±174.7 ml, p= 0.7). Conclusion: Small lumen (12F-14F) ICDT cause substantially less pain than large lumen (<14F) ICDT without significant difference in drainage of pus and duration of hospital stay in children with ET.