Suction evacuation of hemothorax: A prospective study

Stephanie A. Savage, George A. Cibulas, Tyler A. Ward, Corinne A. Davis, Martin Croce, Ben L. Zarzaur

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Although tube thoracostomy is a common procedure after thoracic trauma, incomplete evacuation of fluid places the patient at risk for retained hemothorax.As little as 300 to 500 cm3 of bloodmay result in the need for an additional thoracostomy tube or, inmore severe cases, lung entrapment and empyema.We hypothesized that suction evacuation of the thoracic cavity before tube placement would decrease the incidence of late complications. METHODS: Patients requiring tube thoracostomy within 96 hours of admission were prospectively identified and underwent suction evacuation of the pleural space (SEPS) before tube placement. These patients were compared to historical controlswithout suction evacuation. Demographics, admission vital signs, laboratory values, details of chest tube placement, and outcomes were collected on all patients. Multivariable logistic regression was used to compare outcomes between groups. RESULTS: A total of 199 patients were identified, consisting of 100 retrospective controls and 99 SEPS patients. Therewere no differences in age, sex, admission injury severity score or chest abbreviated injury score, admission laboratory values or vital signs, or hospital length of stay.Mean (SD) volume of hemothorax in SEPS patientswas 220 (297)cm3; with only 48% having a volume greater than 100 cm3 at the time of tube placement. Three patients developed empyema, and 19 demonstrated retained blood; there was no difference between SEPS and control patients. Suction evacuation of the pleural space was significantly protective against recurrent pneumothorax after chest tube removal (odds ratio, 0.332; 95% confidence interval, 0.148-0.745). CONCLUSION: Preemptive suction evacuation of the thoracic cavity did not have a significant impact on subsequent development of retained hemothorax or empyema. Suction evacuation of the pleural space significantly decreased incidence of recurrent pneumothorax after thoracostomy removal. Although the mechanism is unclear, such a benefit may make this simple procedure worthwhile. A larger sample size is required for validation and to determine if preemptive thoracic evacuation has a clinical benefit.

Original languageEnglish (US)
Pages (from-to)58-62
Number of pages5
JournalJournal of Trauma and Acute Care Surgery
Volume81
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Hemothorax
Suction
Prospective Studies
Thoracostomy
Empyema
Thoracic Cavity
Chest Tubes
Vital Signs
Pneumothorax
Length of Stay
Thorax
Thoracic Injuries
Injury Severity Score
Incidence
Sample Size
Logistic Models
Odds Ratio
Demography
Confidence Intervals
Lung

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Savage, S. A., Cibulas, G. A., Ward, T. A., Davis, C. A., Croce, M., & Zarzaur, B. L. (2016). Suction evacuation of hemothorax: A prospective study. Journal of Trauma and Acute Care Surgery, 81(1), 58-62. https://doi.org/10.1097/TA.0000000000001099

Suction evacuation of hemothorax : A prospective study. / Savage, Stephanie A.; Cibulas, George A.; Ward, Tyler A.; Davis, Corinne A.; Croce, Martin; Zarzaur, Ben L.

In: Journal of Trauma and Acute Care Surgery, Vol. 81, No. 1, 01.01.2016, p. 58-62.

Research output: Contribution to journalArticle

Savage, SA, Cibulas, GA, Ward, TA, Davis, CA, Croce, M & Zarzaur, BL 2016, 'Suction evacuation of hemothorax: A prospective study', Journal of Trauma and Acute Care Surgery, vol. 81, no. 1, pp. 58-62. https://doi.org/10.1097/TA.0000000000001099
Savage, Stephanie A. ; Cibulas, George A. ; Ward, Tyler A. ; Davis, Corinne A. ; Croce, Martin ; Zarzaur, Ben L. / Suction evacuation of hemothorax : A prospective study. In: Journal of Trauma and Acute Care Surgery. 2016 ; Vol. 81, No. 1. pp. 58-62.
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