P-238 * TREATMENT OF PRIMARY SPONTANEOUS PNEUMOTHORAX WITH THIN CATHETER DRAINAGE ASSOCIATED WITH HEIMLICH VALVE: COMPARATIVE ANALYSIS

Abstract

Objectives: Spontaneous pneumothorax is divided into primary and secondary distinguishing itself from traumatic and iatrogenic. Current treatments include: observation, needle aspiration, pleural drainage and surgery. The Heimlich valve is a portable device designed for the way outpatient management of a primary spontaneous pneumothorax. We present our experience using a thin catheter pleural drainage associated with Heimlich valve (HV) for the treatment of primary spontaneous pneumothoraces compared with a group of patients treated with conventional chest tube drainage (CCTD). Method(s): Analytical and descriptive, retrospective study, including 126 patients treated for primary spontaneous pneumothoraces (PSP). Between January 2000 and December 2013, 83 patients were treated with an 8 French pleural drainage set with HV and 43 with a conventional 20-28 French chest tube (CCTD) connected to water seal between January 2008 and December 2013. Demographic variables, size and episode of pneumothorax, side affected, surgical time, evacuation and complication rates were similar, without significant statistical difference according to the method used. Patients with secondary, traumatic, iatrogenic, hypertensive and laminar pneumothoraces were excluded. Result(s): in the HV group, 72 patients (86.7%) were managed as outpatients and 11 cases (13.2 %) required hospitalization with an average of 1.3 days. In the CCTD group, the mean hospital stay was 2.6 days (P = 0.001). Only 22 patients (26.5 %) of HV group required intravenous analgesia while in the CCTD group 37 patients (86 %) required it (P = 0.002). The cost in HV group was USD 599 in outpatient and USD 1854 in those requiring hospitalization. In CCTD group all the patients needed hospitalization and the cost was USD 3000. Conclusion(s): The use of HV was satisfactory and safe for the treatment of SPS and may have benefits for the patient's comfort and mobility avoiding hospitalization, lower economic cost compared with conventional pleural drainage.