E-ISSN 2367-699X | ISSN 2367-7414
 

Review Article 


Using chest drain outputs for the blunt trauma patient to guide thoracotomy. A review of literature

Saksham Gupta, Umar Ali.

Abstract
The current Advanced Trauma Life Support guidelines state that immediate output from a chest drain (also referred to as a tube thoracostomy) of >=1500mL or ongoing blood loss of >=200mL hourly for 2-4 hours are indications for thoracotomy, with the rationale being that the rate of ongoing haemorrhage requires open surgical intervention. This figures aims to be pragmatic and easy to follow, particularly for the stressful trauma environment, but oversimplifies thoracic bleeding for the critically injured patient. It does not consider the mechanism of injury (blunt or penetrating), the patientís medical co-morbidities including medications, nor the presence of extra-thoracic injury. Furthermore, patients who have significant tissue injury or ongoing bleeding may potentially be coagulopathic and focussed efforts need to be on haemostatic resuscitation before open surgery is entertained. Blunt injured patients can typically have complicated injury patterns, resulting in bleeding from multiple sites, so it is not surprising that outcomes after thoracotomy are poor. This review article aims to summarise the literature regarding thoracotomy after high chest drain output in the setting of blunt trauma. We excluded papers focussing on resuscitative thoracotomies in peri-arrest patients.

Key words: thoracotomy, chest drain, trauma


 
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How to Cite this Article
Pubmed Style

Gupta S, Ali U. Using chest drain outputs for the blunt trauma patient to guide thoracotomy. A review of literature. Int J Surg Med. 2020; 6(2): 34-37. doi:10.5455/ijsm.chest-drain-blunt-trauma-patient


Web Style

Gupta S, Ali U. Using chest drain outputs for the blunt trauma patient to guide thoracotomy. A review of literature. http://www.ejos.org/?mno=90863 [Access: September 21, 2020]. doi:10.5455/ijsm.chest-drain-blunt-trauma-patient


AMA (American Medical Association) Style

Gupta S, Ali U. Using chest drain outputs for the blunt trauma patient to guide thoracotomy. A review of literature. Int J Surg Med. 2020; 6(2): 34-37. doi:10.5455/ijsm.chest-drain-blunt-trauma-patient



Vancouver/ICMJE Style

Gupta S, Ali U. Using chest drain outputs for the blunt trauma patient to guide thoracotomy. A review of literature. Int J Surg Med. (2020), [cited September 21, 2020]; 6(2): 34-37. doi:10.5455/ijsm.chest-drain-blunt-trauma-patient



Harvard Style

Gupta, S. & Ali, . U. (2020) Using chest drain outputs for the blunt trauma patient to guide thoracotomy. A review of literature. Int J Surg Med, 6 (2), 34-37. doi:10.5455/ijsm.chest-drain-blunt-trauma-patient



Turabian Style

Gupta, Saksham, and Umar Ali. 2020. Using chest drain outputs for the blunt trauma patient to guide thoracotomy. A review of literature. International Journal of Surgery and Medicine, 6 (2), 34-37. doi:10.5455/ijsm.chest-drain-blunt-trauma-patient



Chicago Style

Gupta, Saksham, and Umar Ali. "Using chest drain outputs for the blunt trauma patient to guide thoracotomy. A review of literature." International Journal of Surgery and Medicine 6 (2020), 34-37. doi:10.5455/ijsm.chest-drain-blunt-trauma-patient



MLA (The Modern Language Association) Style

Gupta, Saksham, and Umar Ali. "Using chest drain outputs for the blunt trauma patient to guide thoracotomy. A review of literature." International Journal of Surgery and Medicine 6.2 (2020), 34-37. Print. doi:10.5455/ijsm.chest-drain-blunt-trauma-patient



APA (American Psychological Association) Style

Gupta, S. & Ali, . U. (2020) Using chest drain outputs for the blunt trauma patient to guide thoracotomy. A review of literature. International Journal of Surgery and Medicine, 6 (2), 34-37. doi:10.5455/ijsm.chest-drain-blunt-trauma-patient