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Artikel ; Online: Managing tube thoracostomy with thoracic ultrasound: results from a randomized pilot study.

Fonseca, Alexandre Zanchenko / Kunizaki, Eric / Waisberg, Jaques / Ribeiro, Marcelo Augusto Fontenelle

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2020  Band 48, Heft 2, Seite(n) 973–979

Abstract: Purpose: Tube thoracostomy (TT) is a simple and a life-saving procedure; nevertheless, it carries morbidity, even after its removal. Currently, TT is managed and removed by chest X-ray (CXR) evaluation. There are limitations and these are directly ... ...

Abstract Purpose: Tube thoracostomy (TT) is a simple and a life-saving procedure; nevertheless, it carries morbidity, even after its removal. Currently, TT is managed and removed by chest X-ray (CXR) evaluation. There are limitations and these are directly linked to complications. The use of thoracic ultrasound (US) has already been established in the diagnosis of pneumothorax (PTX) and hemothorax (HTX); its use, in substitution of CXR can lead to improvement in care. Our aim is to evaluate the efficiency and safety of US in the management of TT.
Methods: Prospective and randomized study with patients requiring TT. They were divided in groups according to their thoracic injuries (PTX and HTX) and randomized into two groups according to TT management: US and CXR. Data collected included gender, age, mechanism of injury, days to TT removal, complications after TT removal and presence of mechanical ventilation.
Results: Sixty-one patients were randomized, of which 68.8% were male. The most frequent diagnosis was PTX, present in 37 cases. Median time for TT removal was 2.5 days in the US group and 4.9 in the control group (p = 0.009). The complication rate was 6.6%, with no morbidity in the US group. TT removal in patients with mechanical ventilation did not increase the incidence of complications.
Conclusions: The use of US in the management is efficient and safe. It allows early TT removal regardless the cause of the thoracic injury.
Mesh-Begriff(e) Chest Tubes/adverse effects ; Hemothorax/diagnostic imaging ; Hemothorax/etiology ; Hemothorax/surgery ; Humans ; Male ; Pilot Projects ; Pneumothorax/diagnostic imaging ; Pneumothorax/etiology ; Prospective Studies ; Retrospective Studies ; Thoracic Injuries/complications ; Thoracic Injuries/diagnostic imaging ; Thoracic Injuries/surgery ; Thoracostomy/methods
Sprache Englisch
Erscheinungsdatum 2020-11-26
Erscheinungsland Germany
Dokumenttyp Journal Article ; Randomized Controlled Trial
ZDB-ID 2275480-5
ISSN 1863-9941 ; 1863-9933
ISSN (online) 1863-9941
ISSN 1863-9933
DOI 10.1007/s00068-020-01554-3
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Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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