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Hemothorax and Pneumothorax

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Management of post-traumatic retained hemothorax: a prospective, observational, multicenter AAST study.
DuBose J, Inaba K, Demetriades D, Scalea TM, O'Connor J, Menaker J, Morales C, Konstantinidis A, Shiflett A, Copwood B; AAST Retained Hemothorax Study Group.
J Trauma Acute Care Surg. 2012 Jan;72(1):11-22; discussion 22-4; quiz 316.

Rationale for inclusion: Large, multi-center review of retained hemothoraces found that 1) retained hemothoraces <300cc can often be observed, 2) >900cc often require thoracotomy as do patient who undergo initial chest tube placement without antibiotics.

Citations - 87 (as of July 2017)

Hand-held thoracic sonography for detecting post-traumatic pneumothoraces: the Extended Focused Assessment with Sonography for Trauma (EFAST).
Kirkpatrick AW, Sirois M, Laupland KB, Liu D, Rowan K, Ball CG, Hameed SM, Brown R, Simons R, Dulchavsky SA, Hamiilton DR, Nicolaou S.
J Trauma. 2004 Aug;57(2):288-95.

Rationale for inclusion: EFAST was deemed to be more sensitive and equally specific at pneumothorax detection when compared to AP supine chest x-rays.

Citations - 454 (as of July 2017)

Early evacuation of traumatic retained hemothoraces using thoracoscopy: a prospective, randomized trial.
Meyer DM, Jessen ME, Wait MA, Estrera AS.
Ann Thorac Surg. 1997 Nov;64(5):1396-400; discussion 1400-1.

Rationale for inclusion: Randomized trial comparing second tube placement to VATS found VATS management  to decrease LOS and costs.

Citations - 183 (as of July 2017)

Intrapleural fibrinolysis with streptokinase as an adjunctive treatment in hemothorax and empyema: a multicenter trial.
Jerjes-Sánchez C, Ramirez-Rivera A, Elizalde JJ, Delgado R, Cicero R, Ibarra-Perez C, Arroliga AC, Padua A, Portales A, Villarreal A, Perez-Romo A.
Chest. 1996 Jun;109(6):1514-9.

Rationale for inclusion: Prospective multi-center trial studying the use of streptokinase for loculated pleural effusions.  44 of 48 patients were managed without surgery.

CAVEAT: Patients with empyemas (n=30) were included in the study sample .

Citations - 177 (as of July 2017)

Thoracoscopy for empyema and hemothorax.
Landreneau RJ, Keenan RJ, Hazelrigg SR, Mack MJ, Naunheim KS.
Chest. 1996 Jan;109(1):18-24.

Rationale for inclusion: In a 99 patient study sample, 23 of 23 patients with complex hemothoraces were managed effectively by VATS.

Citations - 253 (as of July 2017)

Tube thoracostomy for occult pneumothorax: a prospective randomized study of its use.
Enderson BL, Abdalla R, Frame SB, Casey MT, Gould H, Maull KI.
J Trauma. 1993 Nov;35(5):726-9; discussion 729-30.

Rationale for inclusion: Prospective randomized trial of tube thoracostomy versus observation for occult pneumothoraces.

Citations - 186 (as of July 2017)

Indications for early thoracotomy in the management of chest trauma.
Kish G, Kozloff L, Joseph WL, Adkins PC.
Ann Thorac Surg. 1976 Jul;22(1):23-8.

Rationale for inclusion: Early civilian series that established indications for thoracotomy still utilized today.

Citations - 122 (as of July 2017)

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