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Updated: Mar 23, 2026

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
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Thoracic irrigation prevents retained hemothorax: a pilot study.

Nathan W Kugler1, Thomas W Carver1, Jasmeet S Paul1

  • 1Division of Trauma and Critical Care, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.

The Journal of Surgical Research
|April 4, 2016
PubMed
Summary

Prophylactic thoracic irrigation during thoracostomy tube placement for retained hemothorax (HTx) significantly reduced the need for secondary interventions. This procedure showed a low complication rate, suggesting it may be a valuable strategy in managing traumatic hemothorax.

Keywords:
Chest tubeHemothoraxPleural lavageRetained hemothoraxThoracic irrigationThoracostomy tube

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Area of Science:

  • Thoracic Surgery
  • Trauma Management
  • Critical Care Medicine

Background:

  • Retained hemothorax (HTx) complicates over 20% of thoracostomy tube (TT) placements, often necessitating further procedures.
  • Effective management strategies for traumatic HTx are crucial to minimize patient morbidity.

Purpose of the Study:

  • To evaluate the efficacy of prophylactic thoracic irrigation in reducing secondary interventions for retained hemothorax.
  • To determine the rate of secondary intervention in patients undergoing thoracic irrigation at the time of TT placement.

Main Methods:

  • A prospective observational study included 20 patients with HTx requiring TT placement.
  • Thoracic irrigation involved evacuating HTx, instilling warmed sterile saline, and re-suctioning via the TT.
  • Standard TT management protocols were followed post-procedure.

Main Results:

  • The secondary intervention rate for retained hemothorax was 5% in the treated group.
  • Nineteen patients received the full 1000-mL irrigation, with most showing improved chest x-ray findings.
  • No adverse events related to pleural lavage were observed.

Conclusions:

  • Thoracic irrigation at the time of TT placement for traumatic HTx may decrease the rate of retained hemothorax.
  • This prophylactic approach appears safe and effective in reducing the need for subsequent interventions.