Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiative
Objectives Percutaneously placed small-bore (14 Fr) catheters and pleural lavage have emerged independently as innovative approaches to hemothorax management. This report describes techniques for combining percutaneous thoracostomy with pleural lavage and presents results from a performance improvem...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2024-02-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/9/1/e001298.full |
| _version_ | 1797289792286752768 |
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| author | Michael A Vella Ryan Peter Dumas Jeremy W Cannon Ali Ali Jay Yelon Carl A Beyer Martha M Brinson Nathaniel McLauchlan Sarah M Joergensen |
| author_facet | Michael A Vella Ryan Peter Dumas Jeremy W Cannon Ali Ali Jay Yelon Carl A Beyer Martha M Brinson Nathaniel McLauchlan Sarah M Joergensen |
| author_sort | Michael A Vella |
| collection | DOAJ |
| description | Objectives Percutaneously placed small-bore (14 Fr) catheters and pleural lavage have emerged independently as innovative approaches to hemothorax management. This report describes techniques for combining percutaneous thoracostomy with pleural lavage and presents results from a performance improvement series of patients managed with percutaneous thoracostomy with immediate lavage.Methods This was a prospective performance improvement series of patients treated at a level 1 trauma center with percutaneous thoracostomy and immediate lavage between April 2021 and May 2023.Results Percutaneous thoracostomy with immediate lavage was used to treat nine hemodynamically normal patients with acute hemothorax. Injuries included both blunt and penetrating mechanisms. 56% of patients presented immediately after injury, and 44% presented in a delayed fashion ranging from 2 to 26 days after injury. Median length of stay was 6 days (IQR 6, 9). Seven patients were discharged home in stable condition, one was discharged to an acute rehabilitation facility, and one was discharged to a skilled nursing facility.Conclusions Percutaneous thoracostomy with pleural lavage is clinically feasible and effective and warrants further evaluation with a multicenter clinical trial.Level of evidence Therapeutic/care management, level V. |
| first_indexed | 2024-03-07T19:11:07Z |
| format | Article |
| id | doaj.art-393b2891dab84d449b0cd081b519c515 |
| institution | Directory Open Access Journal |
| issn | 2397-5776 |
| language | English |
| last_indexed | 2024-03-07T19:11:07Z |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj.art-393b2891dab84d449b0cd081b519c5152024-03-01T03:05:08ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762024-02-019110.1136/tsaco-2023-001298Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiativeMichael A Vella0Ryan Peter Dumas1Jeremy W Cannon2Ali Ali3Jay Yelon4Carl A Beyer5Martha M Brinson6Nathaniel McLauchlan7Sarah M Joergensen8Department of Surgery, University of Rochester Medical Center, Rochester, New York, USADepartment of Surgery, UT Southwestern Medical, Dallas, Texas, USADepartment of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA4 Geriatrics and Stroke Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKSurgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USAPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USASurgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USAPerelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USAPenn Acute Research Collaboration (PARC), University of Pennsylvania, Philadelphia, Pennsylvania, USAObjectives Percutaneously placed small-bore (14 Fr) catheters and pleural lavage have emerged independently as innovative approaches to hemothorax management. This report describes techniques for combining percutaneous thoracostomy with pleural lavage and presents results from a performance improvement series of patients managed with percutaneous thoracostomy with immediate lavage.Methods This was a prospective performance improvement series of patients treated at a level 1 trauma center with percutaneous thoracostomy and immediate lavage between April 2021 and May 2023.Results Percutaneous thoracostomy with immediate lavage was used to treat nine hemodynamically normal patients with acute hemothorax. Injuries included both blunt and penetrating mechanisms. 56% of patients presented immediately after injury, and 44% presented in a delayed fashion ranging from 2 to 26 days after injury. Median length of stay was 6 days (IQR 6, 9). Seven patients were discharged home in stable condition, one was discharged to an acute rehabilitation facility, and one was discharged to a skilled nursing facility.Conclusions Percutaneous thoracostomy with pleural lavage is clinically feasible and effective and warrants further evaluation with a multicenter clinical trial.Level of evidence Therapeutic/care management, level V.https://tsaco.bmj.com/content/9/1/e001298.full |
| spellingShingle | Michael A Vella Ryan Peter Dumas Jeremy W Cannon Ali Ali Jay Yelon Carl A Beyer Martha M Brinson Nathaniel McLauchlan Sarah M Joergensen Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiative Trauma Surgery & Acute Care Open |
| title | Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiative |
| title_full | Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiative |
| title_fullStr | Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiative |
| title_full_unstemmed | Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiative |
| title_short | Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiative |
| title_sort | percutaneous thoracostomy with thoracic lavage for traumatic hemothorax a performance improvement initiative |
| url | https://tsaco.bmj.com/content/9/1/e001298.full |
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