Novel Colorimetric Capnography for Confirmation of Thoracostomy Placement in a Porcine Model of Pneumothorax

Tension pneumothorax is a rapidly fatal but pre ventable cause of death. Needle thoracostomy remains the first-line intervention, yet misplaced catheters fail to relieve pressure and may prolong hypoxia, resulting in cardiovascular compromise and potentially causing injury. This study evaluated the utility of a novel colorimetric capnography device (Capnospot™) designed to provide visual confirmation of pleural entry during decompression.

Two swine models of tension pneumothorax were created using transdiaphragmatic CO2 insufflation. After each induction, either needle or pigtail thoracostomy was performed. Time to Capnospot® color change was compared with ultrasound and radiographic confirmation using the Wilcoxon signed-rank test.

Twenty-four thoracostomies were performed. Time to colorimetric capnography change for needle thoracostomy was shorter than time to ultrasound confirmation (1,030 vs. 7,030 milliseconds (ms), P=.004). Time to color change was shorter than both the time to X-ray confirmation (1,030 vs. 9,435ms, P=.002) and ultrasound confirmation for pigtail thoracostomy placement (355 vs. 22,355ms, P=.002).

Colorimetric capnography provided rapid, reliable confirmation of thoracostomy placement, outperforming both ultrasound and X-ray in speed and accuracy. This technology may streamline decompression in both prehospital and in-hospital settings, reducing complications and delays in life-saving care.