Heier Evelyn, Wurtinger Gabriel, Hassdenteufel Esther, Schneider Matthias
Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University Giessen, 35392 Giessen, Germany.
Animals (Basel). 2022 Jan 3;12(1):107. doi: 10.3390/ani12010107.
First-line therapy for cats with pyothorax consists of intravenous antibiotics, drainage of the septic pleural effusion and closed-chest lavage. Large-bore thoracostomy tubes are traditionally used for drainage, but case series indicate a comparable efficacy using small-bore tubes. In this retrospective study, we describe a new technique of sheath-guided small-bore (6 F) thoracostomy tubes in cats with pyothorax and evaluate their efficacy and complications. Additionally, we compare outcomes between two treatment groups. Placement and use of the small-bore thoracostomy tubes described here has a low complication rate of 4% (3/67 tubes), and 53% (24/45) of the cats could be treated with thoracostomy tubes and closed-chest lavage according to the protocol. The success rate is reduced by 18% (8/45) due to deaths caused mainly by sepsis, 16% (7/45) due to structural diseases requiring surgery and a further 14% (6/43) due to lavage failures that could only be cured after additive therapy (thoracotomy or fibrinolysis). The long-term prognosis was very good, with a survival rate one year after discharge of 94% (30/32). We detected no effect on survival by early placement of bilateral thoracostomy tubes or closed-chest lavage with a heparinised solution. In conclusion, therapy of pyothorax with small-bore thoracostomy tubes is as successful as therapy with large- or medium-bore tubes.
猫脓胸的一线治疗包括静脉注射抗生素、引流感染性胸腔积液和胸腔闭式灌洗。传统上使用大口径胸管进行引流，但病例系列表明使用小口径胸管具有相当的疗效。在这项回顾性研究中，我们描述了一种用于猫脓胸的鞘引导小口径（6F）胸管新技术，并评估其疗效和并发症。此外，我们比较了两个治疗组的结果。此处描述的小口径胸管的放置和使用并发症发生率低，为4%（3/67根胸管），53%（24/45只）的猫可根据方案用胸管和胸腔闭式灌洗进行治疗。由于主要由败血症导致的死亡，成功率降低了18%（8/45），因需要手术的结构性疾病降低了16%（7/45），因灌洗失败仅在附加治疗（开胸手术或纤维蛋白溶解）后才能治愈又降低了14%（6/43）。长期预后非常好，出院一年后的生存率为94%（30/32）。我们未发现早期放置双侧胸管或用肝素化溶液进行胸腔闭式灌洗对生存有影响。总之，小口径胸管治疗脓胸与大口径或中口径胸管治疗一样成功。
