Is routine roentgenography needed after closed tube thoracostomy removal?

John P. Pacanowski, Matthew L. Waack, Brian Daley, Karen S. Hunter, Richard Clinton, Daniel L. Diamond, Blaine Enderson

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Efficacy of chest radiograph protocol after tube thoracostomy tube (CT) removal. Methods: Retrospective review (July of 1995 to July of 1996) of 141 patients with CT followed throughout their hospitalization. Excluded patients died (23 patients) or had thoracotomy (13 patients) before CT removal. Results: A total of 105 patients had 113 CT removed (mean age, 36.9 years; Injury Severity Score = 23.4; CT duration, 5.0 days). Protocol chest radiographs were performed on average at 7.9 and 22.1 hours. Recurrent pneumothorax (RHPTX = new interpleural air) occurring in 12 patients (11%) and persistent pneumothorax (PHPTX = same volume of interpleural air) occurring in 13 patients (12%) caused no clinical problems and were treated without tube replacement. Three patients had symptoms after removal; none had RHPTX. Two patients had clinical signs; one reaccumulated a hemothorax requiring CT replacement, the other improved without replacement. Conclusions: Clinically significant RHPTX/PHPTX after CT removal is infrequent. Signs not symptoms detect CT removal complications. At our institution, chest radiographs are obtained in a delayed manner from protocol and offer no benefit over clinical assessment.

Original languageEnglish (US)
Pages (from-to)684-688
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume48
Issue number4
DOIs
StatePublished - Jan 1 2000

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Thoracostomy
Radiography
Thorax
Pneumothorax
Air
Hemothorax
Injury Severity Score
Thoracotomy
Signs and Symptoms
Hospitalization

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Is routine roentgenography needed after closed tube thoracostomy removal? / Pacanowski, John P.; Waack, Matthew L.; Daley, Brian; Hunter, Karen S.; Clinton, Richard; Diamond, Daniel L.; Enderson, Blaine.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 48, No. 4, 01.01.2000, p. 684-688.

Research output: Contribution to journalArticle

Pacanowski, John P. ; Waack, Matthew L. ; Daley, Brian ; Hunter, Karen S. ; Clinton, Richard ; Diamond, Daniel L. ; Enderson, Blaine. / Is routine roentgenography needed after closed tube thoracostomy removal?. In: Journal of Trauma - Injury, Infection and Critical Care. 2000 ; Vol. 48, No. 4. pp. 684-688.
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abstract = "Background: Efficacy of chest radiograph protocol after tube thoracostomy tube (CT) removal. Methods: Retrospective review (July of 1995 to July of 1996) of 141 patients with CT followed throughout their hospitalization. Excluded patients died (23 patients) or had thoracotomy (13 patients) before CT removal. Results: A total of 105 patients had 113 CT removed (mean age, 36.9 years; Injury Severity Score = 23.4; CT duration, 5.0 days). Protocol chest radiographs were performed on average at 7.9 and 22.1 hours. Recurrent pneumothorax (RHPTX = new interpleural air) occurring in 12 patients (11{\%}) and persistent pneumothorax (PHPTX = same volume of interpleural air) occurring in 13 patients (12{\%}) caused no clinical problems and were treated without tube replacement. Three patients had symptoms after removal; none had RHPTX. Two patients had clinical signs; one reaccumulated a hemothorax requiring CT replacement, the other improved without replacement. Conclusions: Clinically significant RHPTX/PHPTX after CT removal is infrequent. Signs not symptoms detect CT removal complications. At our institution, chest radiographs are obtained in a delayed manner from protocol and offer no benefit over clinical assessment.",
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