This review aims to answer the most common questions in routine surgical practice during the first 48 h of blunt chest trauma (BCT) management. Two authors identified relevant manuscripts published since January 1994 to January 2014. Using preferred reporting items for systematic reviews and meta-analyses statement, they focused on the surgical management of BCT, excluded both child and vascula...

1 of 2 DESCRIPTION A 56-year-old male smoker sustained non-penetrating leftsided chest trauma, following a 2-m fall onto a fl at-topped wooden post. He was in severe pain and respiratory distress in the Emergency Department, with a dramatic degree of fl ail and marked subcutaneous emphysema (see video 1 ). A left side tube thoracostomy was inserted urgently with marked improvement in respirator...

OBJECTIVE to investigate the effect of standardized interventions in the management of tube thoracostomy patients and to assess the independent effect of each intervention. METHODS A chest tube management protocol was assessed in a retrospective cohort study. The tube thoracostomy protocol (TTP) was implemented in August 2012, and consisted of: antimicrobial prophylaxis, chest tube insertion ...

OBJECTIVE Chest tubes induce morbidity such as pain, decrease mobility, increase the risk of infection, and prolong the length of hospital stays. This study evaluates a chest-tube protocol containing a high-drainage threshold and a short time period of drainage. METHODS A retrospective study was performed with data collected from all elective complete video-assisted thoracoscopic (c-VATS) (bi...

The purpose of this article is to evaluate the efficacy of recombinant factor VII (rFVIIa) in the treatment of bleeding following cardiac surgery in a pediatric population. The study included a case series of postcardiac surgical patients with chest tube output of = 4 mL/kg/h for the initial 3 postoperative hours who received rFVIIa. Chest tube output for the 3 hours before and the 3 hours afte...

Although diaphragmatic paralysis is a rare recognized complication of chest tube malposition, Chilaiditi's sign occurring as a result of this complication has never been reported in literature to the best of our knowledge. We describe one such case, which had an interesting clinical sequence of events and radiographic findings and suggest that the medial end of the chest tube should be position...

Background: Approach to treat empyema following pulmonary infection, especially in the second stage, is disputed. Therefore, this research aimed to compare the effect of simple tube thoracostomy versus surgical debridement in complicated parapneumonic empyema management. Methods: This prospective randomized trial was conducted in Thoracic Surgery Department of Imam Khomeini Hospital of Tabriz ...

BACKGROUND A randomized controlled trial of adults with empyema recently demonstrated decreased length of stay in hospital in patients treated with intrapleurally administered dornase alfa and fibrinolytics compared to fibrinolytics alone. Whether this treatment strategy is safe and effective in children remains unknown. METHODS/DESIGN This study protocol is for a superiority, placebo-control...

STUDY OBJECTIVES To determine if therapeutic thoracentesis is as effective as early chest tube placement or no drainage procedure in the treatment of early empyema in rabbits. DESIGN AND INTERVENTIONS An empyema, as evidenced by gross pleural pus and a decreased pleural fluid pH and glucose level, was induced in 49 rabbits. The rabbits were divided into three groups: 16 underwent daily therap...

INTRODUCTION Pleural drainage with chest tube insertion for thoracic trauma is a common and often life-saving technique. Although considered a simple procedure, complication rates have been reported to be 2-25%. We conducted a prospective cohort observational study of emergency pleural drainage procedures to validate the indications for pre-hospital thoracostomy and to identify complications fr...