Traumatic Hemothorax Treatment With 14-Fr Pigtail Catheters or Large Bore (~28Fr) Chest Tubes With Daily Irrigation: A Pilot Single-Arm Intervention Study
University of Pennsylvania
Summary
This HTX treatment study evaluates the effects of chest tube size and the benefits of daily irrigations on acute HTX. 20 acutely injured but stable trauma patients requiring a chest tube for HTX will be enrolled. Patients will be assigned a 28Fr or 14 Fr chest tube with serial lavage and drainage. The endpoints will be HTX volume (by CT scan), complications, additional interventions, hospital length of stay, chest tube duration, provider feedback, and patient-reported outcomes.
Description
This hemothorax (HTX) treatment study will evaluate the effects of chest tube size and daily lavage on HTX management outcomes. A total of 20 stable trauma patients requiring a chest tube for HTX will be recruited and consented. These patients will then undergo either 28Fr or 14Fr chest tube placement, depending on the preference of the treatment team at the time of placement. The study will include 10 patients with each type of chest tube (28Fr and 14Fr). Daily lavage will then be performed at 24h and 48h post-placement. Patients will be compared to historical control patients from the trauma…
Eligibility
- Age range
- 15+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Able to provide consent for the research study 2. More than 15 years of age 3. Presence of acute traumatic HTX or HTX-PTX diagnosed on chest CT scan within 24 hours of injury and clinical indication for drainage (hemothorax of moderate or large size greater then 300 mL) 4. Hemodynamic stability (heart rate 120 beats per minute; systolic blood pressure 90 mmHg) 5. Bilateral or unilateral hemothorax of greater than 300 mL HTX by Mergo Formula from chest CT 6. Able to complete the entire study including randomization, tube placement, lavages and final CT Scan. Exclusion C…
Interventions
- DeviceCLR Irrigator
All enrolled patients will have their hemothorax treated with a CLR device that allows for easy suction and irrigation through indwelling catheters,
- ProcedureSerial Lavage and Drainage
The current protocol is to do a singular lavage and drainage, this study will investigate the benefits of daily lavage.
- Device28 Fr Open Chest Tube
Patients will have a standard 28 Fr open chest tube or a percutaneous 14Fr chest tube placed.
- DevicePercutaneous 14Fr Chest Tube
Patients will have a standard 28 Fr open chest tube, or a percutaneous 14Fr chest tube placed.
Location
- Penn Presbyterian Medical CenterPhiladelphia, Pennsylvania