Episode 922: Chest Tube Irrigation

Emergency Medical Minute

Contributor: Aaron Lessen, MD

Educational Pearls:

• Hemothorax: blood in the pleural cavity, most commonly due to chest trauma

• Treatment: thoracostomy tube for blood drainage

• helps to avoid clotting, scarring, and infection

• A recent study looked at patients with hemothorax who either received or did not receive thoracic irrigation with saline

• Evaluated incidence of secondary intervention, such as video-assisted thoracoscopic surgery (VATS), for persistent hemothorax

• Patients who received irrigation had a slight decrease in secondary intervention frequency

• Multi-center study - all patients who had the irrigation procedure were at two centers

• Study limitation: variability in approaches at each location could be a confounder

• Technique that could potentially prevent future complications

References

1. Carver TW, Berndtson AE, McNickle AG, et al. Thoracic irrigation for prevention of secondary intervention after thoracostomy tube drainage for hemothorax: A Western Trauma Association multi-center study. J Trauma Acute Care Surg. Published online May 20, 2024. doi:10.1097/TA.0000000000004364

2. Yi JH, Liu HB, Zhang M, et al. Management of traumatic hemothorax by closed thoracic drainage using a central venous catheter. J Zhejiang Univ Sci B. 2012;13(1):43-48. doi:10.1631/jzus.B1100161

Summarized by Meg Joyce, MS | Edited by Meg Joyce & Jorge Chalit, OMS3

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