How emergency physicians choose chest tube size for traumatic pneumothorax or hemothorax: a comparison between 28Fr and smaller tube.
Nagoya J Med Sci
; 82(1): 59-68, 2020 Feb.
Article
en En
| MEDLINE
| ID: mdl-32273633
ABSTRACT
Most traumatic pneumothoraxes and hemothoraxes can be managed non-operatively by means of chest tube thoracostomy. This study aimed to investigate how emergency physicians choose chest tube size and whether chest tube size affects patient outcome. We reviewed medical charts of patients who underwent chest tube insertion for chest trauma within 24 hours of admission in this retrospective, single-institution study. Patient characteristics, inserted tube size, risk of additional tube, and complications were evaluated. Eighty-six chest tubes were placed in 64 patients. Sixty-seven tubes were placed initially, and 19 additionally, which was significantly smaller than the initial tube. Initial tube size was 28 Fr in 38 and <28 Fr in 28 patients. Indications were pneumothorax (n=24), hemothorax (n=7), and hemopneumothorax (n=36). Initial tube size was not related to sex, BMI, BSA, indication, ISS, RTS, chest AIS, or respiratory status. An additional tube was placed in the same thoracic cavity for residual pneumothorax (n=13), hemothorax (n=1), hemopneumothorax (n=1), and inappropriate extrapleural placement (n=3). Risk of additional tube placement was not significantly different depending on tube size. No additional tube was placed for tube occlusion or surgical intervention for residual clotted hemothorax. Emergency physicians did not choose tube size depending on patient sex, body size, or situation. Even with a <28 Fr tube placed in chest trauma patients, the risk of residual hemo/pneumothorax and tube occlusion did not increase, and drainage was effective.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neumotórax
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Traumatismos Torácicos
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Pautas de la Práctica en Medicina
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Toracostomía
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Tubos Torácicos
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Servicio de Urgencia en Hospital
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Toma de Decisiones Clínicas
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Hemotórax
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Nagoya J Med Sci
Año:
2020
Tipo del documento:
Article
País de afiliación:
Japón