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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
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Suction evacuation of hemothorax: A prospective study.
Stephanie A Savage1, George A Cibulas, Tyler A Ward
1From the Indiana University-Purdue University (S.A.S, B.L.Z.), Indianapolis, IN; University of Tennessee Health Sciences Center (T.A.W., C.A.D, M.A.C.), Memphis, TN; and University of Michigan Health System (G.A.C.), Ann Arbor, MI.
The Journal of Trauma and Acute Care Surgery
|April 28, 2016
Summary
Suction evacuation of the pleural space (SEPS) before chest tube placement did not reduce retained hemothorax or empyema. However, SEPS significantly decreased recurrent pneumothorax after tube removal, suggesting a potential benefit for this thoracic trauma procedure.
Area of Science:
- Thoracic Surgery
- Trauma Management
- Pulmonary Medicine
Background:
- Tube thoracostomy is standard for thoracic trauma but risks retained hemothorax.
- Incomplete fluid evacuation can lead to lung entrapment and empyema.
- A hypothesis proposed suction evacuation before tube placement to reduce complications.
Purpose of the Study:
- To evaluate the efficacy of suction evacuation of the pleural space (SEPS) prior to tube thoracostomy.
- To determine if SEPS reduces the incidence of retained hemothorax and empyema.
- To assess the impact of SEPS on recurrent pneumothorax after chest tube removal.
Main Methods:
- Prospective study of patients undergoing tube thoracostomy within 96 hours of admission.
- Comparison of patients who underwent SEPS with historical controls who did not.
- Multivariable logistic regression analysis to compare outcomes between groups.
Main Results:
- No significant difference in retained hemothorax or empyema between SEPS and control groups.
- SEPS patients had a mean hemothorax volume of 220 cm, with 48% over 100 cm.
- SEPS significantly reduced the incidence of recurrent pneumothorax after chest tube removal (OR 0.332).
Conclusions:
- Preemptive SEPS did not significantly impact retained hemothorax or empyema rates.
- SEPS demonstrated a significant protective effect against recurrent pneumothorax post-thoracostomy.
- Further research with larger sample sizes is needed to validate these findings and clinical benefits.
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