Hemothorax: A Review of the Literature.

@article{Zeiler2020HemothoraxAR,
  title={Hemothorax: A Review of the Literature.},
  author={Jacob Zeiler and Steven Idell and Scott H. Norwood and Alan Cook},
  journal={Clinical Pulmonary Medicine},
  year={2020}
}
Hemothorax is a collection of blood in the pleural cavity usually from traumatic injury. Chest X-ray has historically been the imaging modality of choice upon arrival to the hospital. The sensitivity and specificity of point-of-care ultrasound, specifically through the Extended Focal Assessment with Sonography in Trauma (eFAST) protocol has been significant enough to warrant inclusion in most Level 1 trauma centers as an adjunct to radiographs.1,2 If the size or severity of a hemothorax… Expand
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References

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Prevalence and Management of Posttraumatic Retained Hemothorax in a Level 1 Trauma Center
TLDR
The prevalence and management of retained hemothorax and to identify risk factors predicting the need for VATS were determined and the rate of patients who underwent VATS and possible risk factors such as initial volume of hemothsorax evacuated and mechanism of injury were determined. Expand
Clinical management of occult hemothorax: a prospective study of 81 patients.
TLDR
Occult hemothorax can be managed successfully without tube thoracostomy in most cases and may be expected in 50% of cases, but did not affect clinical management. Expand
Risk factors associated with the development of post-traumatic retained hemothorax
TLDR
The risk of post-traumatic retained hemothorax was associated with four factors and the probability of the outcome could be modified by careful monitoring, management protocols, suction through the tube thoracostomy, and maybe an early intervention, such as thoracoscopy. Expand
The Epidemiology of Traumatic Hemothorax in a Level I Trauma Center: Case for Early Video-assisted Thoracoscopic Surgery
TLDR
Future research into interventions such as Video-assisted thoracoscopic surgery on the day of admission to completely evacuate hemothorax is warranted to reduce complication rates, length of stay and cost. Expand
Occult pneumothorax in blunt trauma: is there a need for tube thoracostomy?
TLDR
This study suggests that patients with OPTX can be managed conservatively with close monitoring, but only in areas with ready access to emergency facilities should any adverse events occur. Expand
Video-assisted thoracoscopic surgery for retained hemothorax in blunt chest trauma
TLDR
Early VATS intervention within 7 days after injury can decrease the rate of posttraumatic infection and length of hospital stay and N-acetylcysteine and methylene blue were used in animals with blunt chest trauma and found to improve clinical outcomes. Expand
How early should VATS be performed for retained haemothorax in blunt chest trauma?
TLDR
It is suggested that VATS might be delayed by associated injuries, but should not exceed 6 days after trauma, and an early VATS intervention would decrease chest infection and reduce the duration of ventilator dependency. Expand
Uniportal video-assisted thoracoscopic surgery in hemothorax.
TLDR
There is no consensus in the literature regarding the timing for draining hemothorax, but best results are obtained when the drainage is performed within the first 5 days after the onset, and the traditional multi-port approach has evolved in the last years into an uniportal approach that mimics open surgical vantage points utilizing a non-rib-spreading single small incision. Expand
Treatment of haemothorax.
TLDR
Treatment depends on the haemodynamic stability of the patient, the volume of evacuated blood and the occurrence of persistent blood loss, but a surgical approach with VATS or thoracotomy is indicated to prevent subsequent complications. Expand
Video-assisted thoracoscopy in the early diagnosis and management of post-traumatic pneumothorax and hemothorax
TLDR
A treatment protocol prescribing its use 48 h from the traumatic event in all cases of uncontrolled air and/or blood loss is proposed, yielding excellent results, including an uneventful postoperative course, rapid resolution of the signs and symptoms of the chest problem, and no disabling sequelae (empyema and fibrothorax). Expand
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