Details

Autor(en) / Beteiligte

• Symington, Linda
• McGugan, Elizabeth

Titel

BET 1: IS A CHEST DRAIN NECESSARY IN STABLE PATIENTS WITH TRAUMATIC PNEUMOTHORAX?

Ist Teil von

• Emergency medicine journal : EMJ, 2008-07, Vol.25 (7), p.439-440

Ort / Verlag

London: BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine

Erscheinungsjahr

2008

Link zum Volltext

Quelle

BMJ Journals Archiv - DFG Nationallizenzen

Beschreibungen/Notizen

• Author, date, country, Patient group Study type Outcomes Key results Study weaknesses Obeid et al, 1985, USA 34 patients simple traumatic PTX, haemodynamically stable, no other clinically significant injury, no underlying lung disease treated by catheter aspiration or thoracostomy Prospective trial of aspiration Progression to chest drain 6% (1/17) required chest drain for failure of aspiration Small numbers 4 post blunt trauma, 21 iv drug injection, 9 penetrating trauma Clinical deterioration No clinical deterioration in group treated by aspiration Not randomised Control group not studied prospectively High incidence of iv drug use as aetiology-may not be reflective of other populations Knottenbelt and van der Spuy, 1990, South Africa 333 patients with pure unilateral PTX, lung border less than 1.5 cm from chest wall at 3rd rib, not requiring IPPV, no underlying lung disease treated expectantly studied Case series/Prospective observational study of new protocol Progression to chest drainage 8.8% (6/333) required chest drain for radiological progression No control group Clinical deterioration No clinical deterioration in group treated expectantly Rates of complications at follow-up not divided into groups treated expectantly or by thoracostomy Majority of patients with penetrating wounds may not be reflective of other populations Johnson, 1996, UK 53 patients with a diagnosis of traumatic PTX found on department database Retrospective case note review Progression to chest drain 7% (2/29) required chest drain for asymptomatic radiographic progression Retrospective 29 managed expectantly, 24 by thoracostomy Clinical deterioration No clinical deterioration in group treated expectantly No control group 49 post blunt trauma, 4 penetrating trauma No protocol for choice of treatment-at physician discretion Length of follow-up not specified IPPV, intermittent positive-pressure ventilation; PTX, pneumothorax.