Traumatic hemothorax and hemopneumothorax are common diagnoses which are typically treated by placement of a chest tube. 28-32 Fr chest tubes have previously been shown equivalent to 36-40 Fr chest tubes for the non-emergent drainage of hemothorax. A smaller study has found 14 Fr pigtails had less pain than larger tubes but was not powered to compare outcomes. We seek to perform a prospective randomized trial that is adequately powered comparing efficacy of 14 Fr thal tubes to 28 Fr chest tubes for non-emergent drainage of hemothorax and hemopneumothorax. Additionally, we will employ maximal barrier precautions for all chest tube insertions and compare empyema rates to our historical controls.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
193
Placing tube thoracostomy for hemothorax or hemopneumothorax utilizing maximal barrier precautions.
Carolinas Medical Center
Charlotte, North Carolina, United States
Number of Participants With Retained Hemothorax Following Initial Chest Tube Placement Requiring Intervention
Number of Participants with Retained hemothorax requiring an additional intervention, either video-assisted thoracoscopic surgery (VATS) or additional thoracostomy tube placement.
Time frame: 90 days
Duration of Chest Tube Placement.
Number of days with chest tube placement
Time frame: 90 days
Number of Participants Stratified by Length of Hospitalization Stay
Number of weeks spent in hospital
Time frame: 90 days
Change in Subjective Pain Scores From Baseline at 90 Days
Assessed with 0-10 numeric pain rating scale - the higher the number, the more severe the pain
Time frame: 90 days
Hemodynamic Stability Post-insertion
determined by vital signs: temperature, heart rate, blood pressure, oxygen saturation (Systolic Blood Pressure \<90mm Hg)
Time frame: 90 days
Initial Drainage From Chest Tube at 5 Minutes
Milliliters of chest tube drainage at 5 minutes
Time frame: 5 Minutes
Tube Specific Complications: Air Leak, Tube Malposition, & Tube Migration
Number of Tube specific complications: Air leak, tube malposition, \& tube migration
Time frame: 90 days
Time to Radiographic Resolution of Pneumothorax/Hemothorax/Hemopneumothorax
Number of days until radiographic resolution of pneumothorax/hemothorax/hemopneumothorax
Time frame: 90 days
Recurrent Pneumothorax/Hemothorax/Hemopneumothorax After Tube Removal
Number of Participants with Recurrent pneumothorax/hemothorax/hemopneumothorax after tube removal
Time frame: 90 days
Readmission for Chest Tube Related Complications
Number of Participants readmitted for chest tube related complications
Time frame: 90 days
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