Needle Thoracostomy: Implications of Chest Wall Thickness for Anatomical Location and Needle Length

This study aimed to evaluate how chest wall thickness varies at different anatomical locations in patients with class II and III obesity, specifically comparing the second intercostal space in the midclavicular line (ICS 2-MCL) and the fourth/fifth intercostal space in the anterior axillary line (ICS 4/5-AAL). The findings revealed that chest wall thickness was significantly greater at ICS 4/5-AAL, particularly in relation to increasing body mass index (BMI), suggesting that ICS 2-MCL may be a more favorable site for needle thoracostomy due to lower thickness and reduced risk of failure in accessing the pleural space.