BACKGROUND: Occult pneumothoraces (OPTXs) are seen on abdominal computed tomographic (CT) scans but not on routine chest x-ray films. Optimal treatment for blunt trauma OPTXs has not been defined. We hypothesized that OPTXs could be safely observed without need for a chest tube (CT). METHODS: A prospective trial randomized blunt trauma patients with OPTXs to CT scan or observation. Patients were not excluded for positive pressure ventilation. Primary outcome measures were respiratory distress and pneumothoraces progression. RESULTS:Thirty-nine patients with 44 pneumothoraces were enrolled. Eighteen patients received a CT scan, and 21 patients were observed. Nine patients in each group received positive pressure ventilation. There was no difference in overall complication rate. No patient had respiratory distress related to the OPTX or required emergent CT scan. CONCLUSIONS: Observation of OPTX is not associated with an increased incidence of pneumothorax progression or respiratory distress. These pneumothoraces can be safely observed in patients with blunt trauma injury regardless of the need for positive pressure ventilation.
RCT Entities:
BACKGROUND: Occult pneumothoraces (OPTXs) are seen on abdominal computed tomographic (CT) scans but not on routine chest x-ray films. Optimal treatment for blunt trauma OPTXs has not been defined. We hypothesized that OPTXs could be safely observed without need for a chest tube (CT). METHODS: A prospective trial randomized blunt traumapatients with OPTXs to CT scan or observation. Patients were not excluded for positive pressure ventilation. Primary outcome measures were respiratory distress and pneumothoraces progression. RESULTS: Thirty-nine patients with 44 pneumothoraces were enrolled. Eighteen patients received a CT scan, and 21 patients were observed. Nine patients in each group received positive pressure ventilation. There was no difference in overall complication rate. No patient had respiratory distress related to the OPTX or required emergent CT scan. CONCLUSIONS: Observation of OPTX is not associated with an increased incidence of pneumothorax progression or respiratory distress. These pneumothoraces can be safely observed in patients with blunt trauma injury regardless of the need for positive pressure ventilation.
Authors: Chad G Ball; Amy D Wyrzykowski; Andrew W Kirkpatrick; Christopher J Dente; Jeffrey M Nicholas; Jeffrey P Salomone; Grace S Rozycki; John B Kortbeek; David V Feliciano Journal: Can J Surg Date: 2010-06 Impact factor: 2.089
Authors: Chad G Ball; Christopher J Dente; Andrew W Kirkpatrick; Amit D Shah; Ravi R Rajani; Amy D Wyrzykowski; Gary A Vercruysse; Grace S Rozycki; Jeffrey M Nicholas; Jeffrey P Salomone; David V Feliciano Journal: Can J Surg Date: 2010-08 Impact factor: 2.089
Authors: J Montoya; S P Stawicki; D C Evans; D P Bahner; S Sparks; R P Sharpe; J Cipolla Journal: Eur J Trauma Emerg Surg Date: 2015-03-14 Impact factor: 3.693
Authors: Giovanni Volpicelli; Enrico Boero; Nicola Sverzellati; Luciano Cardinale; Marco Busso; Francesco Boccuzzi; Mattia Tullio; Alessandro Lamorte; Valerio Stefanone; Giovanni Ferrari; Andrea Veltri; Mauro F Frascisco Journal: Intensive Care Med Date: 2014-07-24 Impact factor: 17.440