Related Experiment Video
Updated: Jun 30, 2026

Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets
Published on: May 11, 2015
Tension Pneumothorax During Hyperbaric Oxygen Therapy With Pigtail Pleural Catheter: A Case Report and Experimental
1Hyperbaric and Undersea Medical Service - Hospital CIMA, San Jose, Costa Rica.
Introduction:
Tension pneumothorax is a life-threatening complication during hyperbaric oxygen treatment (HBO₂). The presence of a pleural catheter is assumed to mitigate this risk, but its efficiency under hyperbaric conditions remains unclear.
Case Report:
We describe a 37-year-old female undergoing HBO₂ with a pigtail pleural catheter in situ for secondary pneumothorax. The patient developed respiratory and cardiovascular symptoms during decompression. To investigate gas flow dynamics, we conducted an experimental analysis measuring flow resistance in pigtail catheters under chamber pressures up to a chamber gauge pressure of 172.37 kPa. Flow rates were analyzed across a range of differential pressures and catheter fenestration numbers. Gas flow increased non-linearly with pressure but plateaued at higher differentials, indicating drainage limitations. Catheters with fewer fenestrations exhibited significantly reduced flow rates. Under simulated HBO₂ conditions, pressure differentials exceeding 2.4 kPa resulted in delayed gas evacuation, mirroring the clinical event.
Discussion:
This case and experimental study highlight the potential risk of inadequate pneumothorax drainage with pigtail catheters during HBO₂. We recommend decompression rates ≤1 psi/min to mitigate this risk. Further studies are needed to evaluate alternative catheter designs for hyperbaric environments.
Related Concept Videos
Pneumothorax-II
Clinical Manifestations:
Pneumothorax II: Pathophysiology
Pneumothorax-I
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Atelectasis II: Pathophysiology
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue, improving...
Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...

