Abstract

PEREZ CANTU-SACAL, Alberto; TRUEBA-LOZANO, Demian; GARCIA-ESQUEDA, Jonathan  and  VAZQUEZ-MINERO, Juan Carlos. Chest drain in non-surgical thoracic trauma: Experience in a level I trauma center. Neumol. cir. torax [online]. 2014, vol.73, n.4, pp.229-235. ISSN 0028-3746.

Introduction: One third of thoracic injuries require hospitalization and the insertion of a chest drain is the only invasive procedure needed most of the times ( > 85%). Between 7.6-30% of patients undergoing this procedure experience some complication. Material and methods: A retrospective, descriptive, observational study was conducted at the Central Hospital of the Mexican Red Cross with the review of the records of all patients admitted during the period of February 2007 to December 2013 with history of blunt or penetrating trauma and whose injuries required the insertion of a chest drain. Results: 812 patients were included -758 men and 54 women-, between 18-45 years old; 68 had history of blunt chest trauma and 744 of penetrating trauma. The frequency of the injuries that were considered as an indication to insert a chest drain was: 206 pneumothorax, 249 hemothorax and 357 hemopneumothorax. The average dwelling time of the drains was 4.53 days and there were 13 (1.60%) complications recorded, 8 residual pneumothorax needing drain reinsertion and 5 retained hemothorax requiring thoracotomy for resolution. Discussion: Thoracic injuries predominated among males with a ratio of 14:1, most (91.62%) with penetrating mechanism. The occurrence of complications related to the pleural cavity was evaluated in the period between the placement of the chest drain and the first consultation a week after its withdrawal; these were observed only in 1.60% of patients and only 0.61%of them required surgery, involving a reduction of 78.95 and 93.90% in comparison with the studies analyzed; in addition, the average dwelling time of the probes was 4.53 days, i.e. 30.95% less than in the reviewed literature. Conclusions: Our protocol for handling chest drains in trauma situations has proven to be an effective technique with almost no inherent complications.

Keywords : Chest drain; chest trauma; pneumothorax; hemothorax.

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