Faculty Collaboration Database

Thoracic irrigation prevents retained hemothorax: a pilot study. J Surg Res 2016 May 15;202(2):443-8

Date

04/04/2016

Pubmed ID

27038661

DOI

10.1016/j.jss.2016.02.046

Scopus ID

2-s2.0-84962069492 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

BACKGROUND: Upward of 20% of patients undergoing thoracostomy tube (TT) placement develop retained hemothorax (HTx) requiring secondary intervention. The aim of this study was to define the rate of secondary intervention in patients undergoing prophylactic thoracic irrigation.

METHODS: A prospective observational trial of 20 patients who underwent thoracic irrigation at the time of TT placement was conducted. Patients with HTx identified on chest x-ray were included. After standard placement of a 36-French TT, the HTx was evacuated using a sterile suction catheter advanced within the TT. Warmed sterile saline was instilled into the chest through the TT followed by suction catheter evacuation. The TT was connected to the sterile drainage atrium and suction applied. TTs were managed in accordance with our standard division protocol.

RESULTS: The population was predominantly (70%) male at median age 35 years, median ISS 13, with 55% suffering penetrating trauma. Thirteen (65%) patients underwent TT placement within 6 h of trauma with the remainder within 24 h. Nineteen patients received the full 1000-mL irrigation. The majority demonstrated significant improvement on postprocedure chest x-ray. The secondary intervention rate was 5%. A single patient required VATS on post-trauma day zero for retained HTx. Median TT duration was 5 d with median length of stay of 7 d. No adverse events related to the pleural lavage were noted.

CONCLUSIONS: Thoracic irrigation at the time of TT placement for traumatic HTx may decrease the rate of retained HTx.

Author List

Kugler NW, Carver TW, Paul JS

Authors

Thomas W. Carver MD Associate Professor in the Surgery department at Medical College of Wisconsin
Nathan W. Kugler MD Assistant Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Chest Tubes
Female
Follow-Up Studies
Hemothorax
Humans
Male
Middle Aged
Pilot Projects
Postoperative Complications
Prospective Studies
Suction
Therapeutic Irrigation
Thoracostomy
Treatment Outcome
Young Adult