Treatment of occult pneumothoraces from blunt trauma. J Trauma 1999 Jun;46(6):987-90; discussion 990-1
Date
06/18/1999Pubmed ID
10372613DOI
10.1097/00005373-199906000-00001Scopus ID
2-s2.0-0033059763 (requires institutional sign-in at Scopus site) 126 CitationsAbstract
BACKGROUND: Occult pneumothoraces (OPTXs) are seen on abdominal computed tomographic (CT) scans but not on routine chest x-ray films. Optimal treatment for blunt trauma OPTXs has not been defined. We hypothesized that OPTXs could be safely observed without need for a chest tube (CT).
METHODS: A prospective trial randomized blunt trauma patients with OPTXs to CT scan or observation. Patients were not excluded for positive pressure ventilation. Primary outcome measures were respiratory distress and pneumothoraces progression.
RESULTS: Thirty-nine patients with 44 pneumothoraces were enrolled. Eighteen patients received a CT scan, and 21 patients were observed. Nine patients in each group received positive pressure ventilation. There was no difference in overall complication rate. No patient had respiratory distress related to the OPTX or required emergent CT scan.
CONCLUSIONS: Observation of OPTX is not associated with an increased incidence of pneumothorax progression or respiratory distress. These pneumothoraces can be safely observed in patients with blunt trauma injury regardless of the need for positive pressure ventilation.
Author List
Brasel KJ, Stafford RE, Weigelt JA, Tenquist JE, Borgstrom DCMESH terms used to index this publication - Major topics in bold
AdultHumans
Pneumothorax
Prospective Studies
Tomography, X-Ray Computed
Wounds, Nonpenetrating
