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

Abstract

Introduction: 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.

Methods: 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.

Results: 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).

Conclusions: 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.