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The effect of two different methods of pleural space catheter insertion on its consequences in critical care patients with and without ultrasound guidance: A clinical trial
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Zahra Fakhra   , Ali Bahramifar * , Reza Ghanbarpour , Seyed Jalal Madani , Mojtaba Sepandi |
| Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran , alibahramifar6@gmail.com |
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Abstract: (71 Views) |
Background and Aim: Pleural effusion is common among critically ill patients and often necessitates therapeutic drainage. Although ultrasound guidance is widely used, direct comparative evidence between ultrasound-guided and landmark-based pleural catheter insertion in intensive care unit (ICU) settings remains limited. This randomized clinical trial aimed to compare the technical and clinical outcomes of these two approaches.
Methods: Patients with clinically significant pleural effusion requiring therapeutic drainage were randomized (1:1) to either the ultrasound-guided group or the landmark-based group. All procedures were performed using the Seldinger technique. Primary outcomes were first-attempt success and incidence of pneumothorax. Secondary outcomes included initial drainage volume, major bleeding, catheter-site infection, number of attempts, duration of mechanical ventilation, and ICU length of stay. Ethical approval was obtained (code: IR.BMSU.BAQ.REC.1402.093).
Results: A total of 68 patients were analyzed. First-attempt success was significantly higher in the ultrasound-guided group (31/34 vs. 23/34; p=0.033; odds ratio [OR] = 4.94, 95% confidence interval [CI]: 1.24–19.76). Multiple attempts were more frequent in the landmark group. No significant differences were observed between groups in pneumothorax incidence, drainage volume, duration of mechanical ventilation, or ICU length of stay (p>0.05 for all). No major bleeding or procedure-related complications occurred.
Conclusion: Ultrasound guidance significantly improves technical accuracy and first-attempt success during pleural catheter insertion; however, broader systemic outcomes remain unaffected. This approach may be preferred in critically ill patients when rapid procedural success and reduced mechanical complications are clinically important. |
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| Keywords: Pleural effusion, Pleural catheterization, Ultrasound, Intensive care, Pneumothorax |
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Full-Text [PDF 641 kb]
(51 Downloads)
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Type of Study: Original Article |
Subject:
Marine Medicine
Received: 2025/11/29 | Accepted: 2025/12/23 | Published: 2026/04/30
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