Clinical management of occult hemothorax: a prospective study of 81 patients.

Abstract:

BACKGROUND:Intrapleural blood detected by computed tomography scan, but not evident on plain chest radiograph, defines occult hemothorax. This study determined the role for tube thoracostomy. METHODS:Hemothorax was quantified on computed tomography by measuring the deepest lamellar fluid stripe at the most dependent portion. Data were collected prospectively on demographics, injury mechanism/severity, chest injuries, mechanical ventilation, hospital length of stay, complications, and outcome. Indications for tube thoracostomy were recorded. RESULTS:Tube thoracostomy was avoided in 67 patients (83%). Indications for chest tube placement included progression of hemothorax (8), desaturation (4), and delayed hemothorax (2). Patients with intrapleural fluid thickness greater than 1.5 cm were 4 times more likely to require tube thoracostomy. CONCLUSIONS:Occult hemothorax can be managed successfully without tube thoracostomy in most cases. Mechanical ventilation is not an indication for chest tube placement. Accompanying occult pneumothorax may be expected in 50% of cases, but did not affect clinical management.

journal_name

Am J Surg

authors

Mahmood I,Abdelrahman H,Al-Hassani A,Nabir S,Sebastian M,Maull K

doi

10.1016/j.amjsurg.2010.04.017

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

766-9

issue

6

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(10)00441-1

journal_volume

201

pub_type

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