Successful management of occult pneumothorax without tube thoracostomy despite positive pressure ventilation

Cristobal Barrios, Tuan Tran, Darren Malinoski, Michael Lekawa, Matthew Dolich, Stephanie Lush, David Hoyt, Marianne E. Cinat

    Research output: Contribution to journalArticle

    23 Scopus citations

    Abstract

    The objective of this study was to determine whether tube thoracostomy can be safely avoided in a subset of patients with blunt occult pneumothorax. A retrospective review was performed. Management without tube thoracostomy was attempted for 59 occult pneumothoraces and was successful in 51 (86%). Observation was successful in 16 of 20 occult pneumothoraces (80%) exposed to positive pressure ventilation within 72 hours of admission. Eight delayed tube thoracostomies were required an average of 19.7 hours post admission. Patients who failed observant management had more significant physiologic derangement on admission (revised trauma score 6.96 vs 7.66, P = 0.04), were more likely to have significant multisystem trauma (88% vs 37%, P = 0.007), but were not more likely to require positive pressure ventilation (PPV) (50% vs 31%, P = 0.31). This study demonstrates that a subset of patients with blunt occult pneumothorax requiring positive pressure ventilation may be safely managed without tube thoracostomy.

    Original languageEnglish (US)
    Pages (from-to)958-961
    Number of pages4
    JournalAmerican Surgeon
    Volume74
    Issue number10
    StatePublished - Oct 1 2008

    ASJC Scopus subject areas

    • Surgery

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  • Cite this

    Barrios, C., Tran, T., Malinoski, D., Lekawa, M., Dolich, M., Lush, S., Hoyt, D., & Cinat, M. E. (2008). Successful management of occult pneumothorax without tube thoracostomy despite positive pressure ventilation. American Surgeon, 74(10), 958-961.