{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T09:39:25Z","timestamp":1786700365556,"version":"build-2736575974"},"reference-count":37,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Pleural pigtail catheters are widely used in intensive care units (ICUs), but factors associated with unplanned removal remain incompletely characterized. Methods: We conducted a single-center retrospective cohort study of adult ICU catheter-placement episodes from December 2020 to March 2025. Effusions were grouped as complex (exudative, empyema, malignant, or malignancy-related) or simple (transudative or hemothorax). The primary outcome was unplanned removal for a catheter-related complication or escalation to surgery. Associations were evaluated using Firth penalized logistic regression. Results: Among 175 screened episodes, 140 were analyzed; unplanned removal occurred in 12 (8.6%). Complex effusions (adjusted odds ratio [aOR] 6.50, 95% confidence interval [CI] 1.59\u201326.55) and ultrasound-assisted insertion (aOR 10.72, 95% CI 1.92\u201359.94) were associated with higher odds of unplanned removal. Reclassifying hemothorax as complex attenuated but did not reverse the phenotype association (aOR 4.84, 95% CI 1.17\u201319.93). The ultrasound association may reflect case selection, operator workflow, or procedural complexity rather than causality. Because 33 death-related episodes were excluded, the 8.6% rate applies to episodes with classifiable non-death endpoints, not all screened episodes. Conclusions: These findings are hypothesis-generating and insufficient to change clinical practice without prospective multicenter validation.<\/jats:p>","DOI":"10.3390\/life16081331","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T09:04:01Z","timestamp":1786698241000},"page":"1331","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pleural Effusion Phenotype and Ultrasound Guidance Approach Associated with Unplanned Pigtail Pleural Catheter Removal in an Adult Intensive Care Unit: A Single-Center Retrospective Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8179-0486","authenticated-orcid":false,"given":"Wei-Hung","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan"},{"name":"Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0276-1500","authenticated-orcid":false,"given":"Kuan-Pen","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Kuo","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Chest Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei 10449, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1378\/chest.111.4.1018","article-title":"Pleural effusions in the medical ICU: Prevalence, causes, and clinical implications","volume":"111","author":"Mattison","year":"1997","journal-title":"Chest"},{"key":"ref_2","first-page":"e0070","article-title":"Clinically significant pleural effusion in intensive care: A prospective multicentre cohort study","volume":"2","author":"Fysh","year":"2020","journal-title":"Crit. 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