PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 7316034

Systematic approach to traumatic hemothorax.

P H Weil·I B Margolis
View original source ↗Export metadata ↓

Abstract

We reviewed 395 patients with isolated hemo- or hemopneumothorax from penetrating injuries. All patients were treated with immediate insertion of a chest tube and drainage of various amounts of blood up to 1,500 ml. Forty-five patients (11 percent) were in hemorrhagic shock on admission to the hospital emergency room, and all were resuscitated with volume replacement. Twenty-one patients (5.3 percent) whose blood pressure decreased again were found on exploration to have lacerated internal mammary or intercostal arteries or major lung lacerations extending into the hilus. All other patients were treated aggressively with chest tubes, aspiration of residual blood and fibrinolytic enzymes until the lung was fully expanded. We conclude that the clinical course of patients with hemothorax after insertion of a chest tube should determine whether exploration is necessary or whether nonoperative treatment should continue.

Explore related subjects

DrainageHemopneumothoraxHemothoraxHumansThoracic SurgeryWounds, PenetratingJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

P H Weil, I B Margolis. 1981. Systematic approach to traumatic hemothorax.. https://doi.org/10.1016/0002-9610(81)90313-5

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Traditional Foley drainage systems--do they drain the bladder?

PURPOSE: Foley catheters are assumed to drain the bladder to completion. Drainage characteristics of Foley catheter systems are poorly understood. To investigate unrecognized retained urine with Foley catheter drainage systems, bladder volumes of hospitalized patients were measured with bladder scan ultrasound volumetrics. Additionally, an in vitro bench top mock bladder and urinary catheter system was developed to understand the etiology of such residual volumes. A novel drainage tube design that optimizes indwelling catheter drainage was also designed. MATERIALS AND METHODS: Bedside bladder ultrasound volumetric studies were performed on patients hospitalized in ward and intensive care unit. If residual urine was identified the drainage tubing was manipulated to facilitate drainage. An ex vivo bladder-urinary catheter model was designed to measure flow rates and pressures within the drainage tubing of a traditional and a novel drainage tube system. RESULTS: A total of 75 patients in the intensive care unit underwent bladder ultrasound volumetrics. Mean residual volume was 96 ml (range 4 to 290). In 75 patients on the hospital ward mean residual volume was 136 ml (range 22 to 647). In the experimental model we found that for every 1 cm in curl height, obstruction pressure increased by 1 cm H2O within the artificial bladder. In contrast, the novel spiral-shaped drainage tube demonstrated rapid (0.5 cc per second), continuous and complete (100%) reservoir drainage in all trials. CONCLUSIONS: Traditional Foley catheter drainage systems evacuate the bladder suboptimally. Outflow obstruction is caused by air-locks that develop within curled redundant drainage tubing segments. The novel drainage tubing design eliminates gravity dependent curls and associated air-locks, optimizes flow, and minimizes residual bladder urine.

Drainage↗