Table 1
Author, date and countryPatient groupStudy type (level of evidence)OutcomesKey resultsStudy weaknesses
Ahmed MY et al, 1995, USA24 children aged 4 months to 24 years from a single paediatric ICU.Retrospective single centre case seriesTime for insertion4 to 7 minutesNo control group
Drains inserted with deep sedation using size 10 to 20 F drainsComplications5 tubes became kinked, causing 4 pneumothoraces to recur. 2 drains had to be reinserted. Otherwise no major complicationsDifferent scenario to the emergency department
Patz ER Jr et al, 1998, USA106 patients having elective insertion of a small-bore catheter for sclerotherapy for malignant pleural effusion.Prospective case seriesSuccess of insertionNo insertion failures reportedSub-study of a sclerotherapy trial
InfectionsNo infections reportedNot directly relevant to our clinical question
14 F small bore catheter was inserted by seldinger technique, with image guidanceOther complicationsPain scores for insertion not done but stated that technique was well toleratedOutcome measures were not defined before study
Roberts JS et al, 1998, USA133 chest catheters inserted into 91 children in ICU. Age range 0–18 years. Weight 1.8–66 kgRetrospective case seriesPneumothorax resolution15 of 20 patients who had drain for pneumothorax had complete resolution (75%)80% had congenital heart disease
67% intubated
7 to 8.5 F percutaneous pigtail catheters inserted in conjunction with wire and dilator by seldinger techniqueComplicationsHaemothorax (2%) 
 Pneumothorax (2%) 
 Emphysema (1%)Not directly relevant to the emergency department
Cannulation of hepatic vein (1 pt)
 Failure to drain pneumothorax (11%)
 Dislogement (5%)
 1/3rd of complications were in infants <5 kgRetrospective uncontrolled methodology