A formula for the determination of appropriate chest tube size and length of insertion in children

Abstract

Objective: The study was carried out to develop a formula that uses the child’s age or body surface area(BSA) to determine the appropriate size and length of the chest tube to be inserted.
Methodology: Children aged 12 years and below who had chest tube insertion at the National Cardiothoracic Centre from July 2015 to August 2016 were retrospectively enrolled into the study. The inclusion criterion was those who had the chest tube data recorded in their notes. This was the derivative cohort. The chest tube type used was SURUCATH ULTRA®. The BSA was calculated using the Mosteller formula. The statistical analysis was performed using Microsoft excel 2013. The data of the derivative cohort was plotted on a graph, and an equation was deduced from the graph, representing the data. This equation is the formula. The formula was then used to determine the appropriate chest tube size and length of insertion on a validation cohort from January 2021 to April 2022.
Results: In the derivative cohort, there were 50 children, 34.0% being males. The mean age was 4.2 ± 2.9 years. The weight ranged from 3.5 – 50 kg, the height ranged from 50 – 159 cm and the body surface area ranged from 0.2 – 1.5 m². In the validation cohort, there were 56 children, 48.0% being males. The mean age was 4.4 ± 2.8. The weight ranged from 5 – 40 kg, the height ranged from 54 – 152 cm and the body surface area ranged from 0.3 – 1.3 m². The outcome of the validation was good. The chest tubes functioned well and there were no chest tube-associated complications. The formulae obtained were S (FG) = A + 16, L (cm) = 0.3A + 3.5, S (FG) = 6B + 16, L (cm) = 3.5B + 3, where S is the size of the chest tube, A is the age in years, L is the length of insertion and B is the body surface area. The L is the length of the tube that has gone into the chest.
Conclusion: A formula has been developed to guide in determining the most appropriate chest tube size and length of insertion in children, using the age and body surface area.