Outcome of Concurrent Occult Hemothorax and Pneumothorax in Trauma Patients Who Required Assisted Ventilation
Background. The management and outcomes of occult hemopneumothorax in blunt trauma patients who required mechanical ventilation are not well studied. We aimed to study patients with occult hemopneumothorax on mechanical ventilation who could be carefully managed without tube thoracostomy. Methods. C...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2015-01-01
|
| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2015/859130 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832548981630042112 |
|---|---|
| author | Ismail Mahmood Zainab Tawfeek Ayman El-Menyar Ahmad Zarour Ibrahim Afifi Suresh Kumar Ruben Peralta Rifat Latifi Hassan Al-Thani |
| author_facet | Ismail Mahmood Zainab Tawfeek Ayman El-Menyar Ahmad Zarour Ibrahim Afifi Suresh Kumar Ruben Peralta Rifat Latifi Hassan Al-Thani |
| author_sort | Ismail Mahmood |
| collection | DOAJ |
| description | Background. The management and outcomes of occult hemopneumothorax in blunt trauma patients who required mechanical ventilation are not well studied. We aimed to study patients with occult hemopneumothorax on mechanical ventilation who could be carefully managed without tube thoracostomy. Methods. Chest trauma patients with occult hemopneumothorax who were on mechanical ventilation were prospectively evaluated. The presence of hemopneumothorax was confirmed by CT scanning. Hospital length of stay, complications, and outcome were recorded. Results. A total of 56 chest trauma patients with occult hemopneumothorax who were on ventilatory support were included with a mean age of 36 ± 13 years. Hemopneumothorax was managed conservatively in 72% cases and 28% underwent tube thoracostomy as indicated. 29% of patients developed pneumonia, 16% had Acute Respiratory Distress Syndrome (ARDS), and 7% died. Thickness of hemothorax, duration of mechanical ventilation, and development of ARDS were significantly associated with tube thoracostomy in comparison to no-chest tube group. Conclusions. The majority of occult hemopneumothorax can be carefully managed without tube thoracostomy in patients who required positive pressure ventilation. Tube thoracotomy could be restricted to those who had evidence of increase in the size of the hemothorax or pneumothorax on follow-up chest radiographs or developed respiratory compromise. |
| format | Article |
| id | doaj-art-e5fc640ffe604826b1091d10c82d055d |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-e5fc640ffe604826b1091d10c82d055d2025-02-03T06:12:36ZengWileyEmergency Medicine International2090-28402090-28592015-01-01201510.1155/2015/859130859130Outcome of Concurrent Occult Hemothorax and Pneumothorax in Trauma Patients Who Required Assisted VentilationIsmail Mahmood0Zainab Tawfeek1Ayman El-Menyar2Ahmad Zarour3Ibrahim Afifi4Suresh Kumar5Ruben Peralta6Rifat Latifi7Hassan Al-Thani8Department of Surgery, Section of Trauma Surgery, Hamad General Hospital, P.O. Box 3050, Doha, QatarDepartment of Emergency, Hamad Medical Corporation, P.O. Box 3050, Doha, QatarClinical Research, Section of Trauma Surgery, Hamad General Hospital, Doha, QatarDepartment of Surgery, Section of Trauma Surgery, Hamad General Hospital, P.O. Box 3050, Doha, QatarDepartment of Surgery, Section of Trauma Surgery, Hamad General Hospital, P.O. Box 3050, Doha, QatarDepartment of Surgery, Section of Trauma Surgery, Hamad General Hospital, P.O. Box 3050, Doha, QatarDepartment of Surgery, Section of Trauma Surgery, Hamad General Hospital, P.O. Box 3050, Doha, QatarDepartment of Surgery, Section of Trauma Surgery, Hamad General Hospital, P.O. Box 3050, Doha, QatarDepartment of Surgery, Section of Trauma Surgery, Hamad General Hospital, P.O. Box 3050, Doha, QatarBackground. The management and outcomes of occult hemopneumothorax in blunt trauma patients who required mechanical ventilation are not well studied. We aimed to study patients with occult hemopneumothorax on mechanical ventilation who could be carefully managed without tube thoracostomy. Methods. Chest trauma patients with occult hemopneumothorax who were on mechanical ventilation were prospectively evaluated. The presence of hemopneumothorax was confirmed by CT scanning. Hospital length of stay, complications, and outcome were recorded. Results. A total of 56 chest trauma patients with occult hemopneumothorax who were on ventilatory support were included with a mean age of 36 ± 13 years. Hemopneumothorax was managed conservatively in 72% cases and 28% underwent tube thoracostomy as indicated. 29% of patients developed pneumonia, 16% had Acute Respiratory Distress Syndrome (ARDS), and 7% died. Thickness of hemothorax, duration of mechanical ventilation, and development of ARDS were significantly associated with tube thoracostomy in comparison to no-chest tube group. Conclusions. The majority of occult hemopneumothorax can be carefully managed without tube thoracostomy in patients who required positive pressure ventilation. Tube thoracotomy could be restricted to those who had evidence of increase in the size of the hemothorax or pneumothorax on follow-up chest radiographs or developed respiratory compromise.http://dx.doi.org/10.1155/2015/859130 |
| spellingShingle | Ismail Mahmood Zainab Tawfeek Ayman El-Menyar Ahmad Zarour Ibrahim Afifi Suresh Kumar Ruben Peralta Rifat Latifi Hassan Al-Thani Outcome of Concurrent Occult Hemothorax and Pneumothorax in Trauma Patients Who Required Assisted Ventilation Emergency Medicine International |
| title | Outcome of Concurrent Occult Hemothorax and Pneumothorax in Trauma Patients Who Required Assisted Ventilation |
| title_full | Outcome of Concurrent Occult Hemothorax and Pneumothorax in Trauma Patients Who Required Assisted Ventilation |
| title_fullStr | Outcome of Concurrent Occult Hemothorax and Pneumothorax in Trauma Patients Who Required Assisted Ventilation |
| title_full_unstemmed | Outcome of Concurrent Occult Hemothorax and Pneumothorax in Trauma Patients Who Required Assisted Ventilation |
| title_short | Outcome of Concurrent Occult Hemothorax and Pneumothorax in Trauma Patients Who Required Assisted Ventilation |
| title_sort | outcome of concurrent occult hemothorax and pneumothorax in trauma patients who required assisted ventilation |
| url | http://dx.doi.org/10.1155/2015/859130 |
| work_keys_str_mv | AT ismailmahmood outcomeofconcurrentocculthemothoraxandpneumothoraxintraumapatientswhorequiredassistedventilation AT zainabtawfeek outcomeofconcurrentocculthemothoraxandpneumothoraxintraumapatientswhorequiredassistedventilation AT aymanelmenyar outcomeofconcurrentocculthemothoraxandpneumothoraxintraumapatientswhorequiredassistedventilation AT ahmadzarour outcomeofconcurrentocculthemothoraxandpneumothoraxintraumapatientswhorequiredassistedventilation AT ibrahimafifi outcomeofconcurrentocculthemothoraxandpneumothoraxintraumapatientswhorequiredassistedventilation AT sureshkumar outcomeofconcurrentocculthemothoraxandpneumothoraxintraumapatientswhorequiredassistedventilation AT rubenperalta outcomeofconcurrentocculthemothoraxandpneumothoraxintraumapatientswhorequiredassistedventilation AT rifatlatifi outcomeofconcurrentocculthemothoraxandpneumothoraxintraumapatientswhorequiredassistedventilation AT hassanalthani outcomeofconcurrentocculthemothoraxandpneumothoraxintraumapatientswhorequiredassistedventilation |