TY - JOUR
T1 - Results of conservative treatment in patients with occult pneumothorax
AU - Montmany Vioque, Sandra
AU - Rebasa, Pere
AU - Navarro Soto, Salvador
AU - Llaquet Bayo, Heura
PY - 2016/4/1
Y1 - 2016/4/1
N2 - © 2014 AEC. Introduction: An occult pneumothorax is found in 2-15% trauma patients. Observation (without tube thoracostomy) in these patients presents still some controversies in the clinical practice. The objective of the study is to evaluate the efficacy and the adverse effects when observation is performed. Methods: A retrospective observational study was undertaken in our center (university hospital level II). Data was obtained from a database with prospective registration. A total of 1087 trauma patients admitted in the intensive care unit from 2006 to 2013 were included. Results: In this period, 126 patients with occult pneumothorax were identified, 73 patients (58%) underwent immediate tube thoracostomy and 53 patients (42%) were observed. Nine patients (12%) failed observation and required tube thoracostomy for pneumothorax progression or hemothorax. No patient developed a tension pneumothorax or experienced another adverse event related to the absence of tube thoracostomy. Of the observed patients 16 were under positive pressure ventilation, in this group 3 patients (19%) failed observation. There were no differences in mortality, hospital length of stay or intensive care length of stay between the observed and non-observed group. Conclusion: Observation is a safe treatment in occult pneumothorax, even in pressure positive ventilated patients.
AB - © 2014 AEC. Introduction: An occult pneumothorax is found in 2-15% trauma patients. Observation (without tube thoracostomy) in these patients presents still some controversies in the clinical practice. The objective of the study is to evaluate the efficacy and the adverse effects when observation is performed. Methods: A retrospective observational study was undertaken in our center (university hospital level II). Data was obtained from a database with prospective registration. A total of 1087 trauma patients admitted in the intensive care unit from 2006 to 2013 were included. Results: In this period, 126 patients with occult pneumothorax were identified, 73 patients (58%) underwent immediate tube thoracostomy and 53 patients (42%) were observed. Nine patients (12%) failed observation and required tube thoracostomy for pneumothorax progression or hemothorax. No patient developed a tension pneumothorax or experienced another adverse event related to the absence of tube thoracostomy. Of the observed patients 16 were under positive pressure ventilation, in this group 3 patients (19%) failed observation. There were no differences in mortality, hospital length of stay or intensive care length of stay between the observed and non-observed group. Conclusion: Observation is a safe treatment in occult pneumothorax, even in pressure positive ventilated patients.
KW - Tube thoracostomy
KW - Multiple trauma
KW - Tomography
KW - Positive-pressure ventilation
KW - Occult pneumothorax
KW - Radiography thoracic
UR - https://dialnet.unirioja.es/servlet/articulo?codigo=5406228
U2 - 10.1016/j.ciresp.2015.01.010
DO - 10.1016/j.ciresp.2015.01.010
M3 - Article
SN - 0009-739X
VL - 94
SP - 232
EP - 236
JO - Cirugia Espanola
JF - Cirugia Espanola
IS - 4
ER -