Hypobaria and Traumatic Pneumothorax
| Status: | Completed |
|---|---|
| Conditions: | Hospital |
| Therapuetic Areas: | Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 5/3/2014 |
| Start Date: | October 2012 |
| End Date: | August 2014 |
| Contact: | Sarah Majercik, MD, MBA |
| Email: | sarah.majercik@imail.org |
| Phone: | 314-288-8957 |
The Effects of Hypobaric Conditions on Small, Traumatic Pneumothoraces
The purpose of this research is to see if people who have had a collapsed lung that has been
re-expanded can be safely taken to an elevation that a person might experience while in a
commercial airplane without having their lung partially collapse again, or have any symptoms
such as feeling short of breath or having oxygen levels in the blood decrease while at the
simulated altitude.
The investigators hypothesize that subjects who have had a collapsed lung that has been
re-expanded will not have any adverse symptoms or signs while subjected to a simulated
altitude of 8400 feet (565mm Hg) or 12650 ft (471mm Hg).
re-expanded can be safely taken to an elevation that a person might experience while in a
commercial airplane without having their lung partially collapse again, or have any symptoms
such as feeling short of breath or having oxygen levels in the blood decrease while at the
simulated altitude.
The investigators hypothesize that subjects who have had a collapsed lung that has been
re-expanded will not have any adverse symptoms or signs while subjected to a simulated
altitude of 8400 feet (565mm Hg) or 12650 ft (471mm Hg).
The investigators will study patients who have been diagnosed with a unilateral traumatic
pneumothorax that has been treated. Treatment for pneumothorax may consist of high-flow
oxygen therapy in the case of very small or "occult" pneumothorax, or tube thoracostomy
("chest tube") in the case of larger pneumothorax. Treatment for pneumothorax will be at
the discretion of the attending trauma surgeon. Once the pneumothorax has radiographically
resolved, the chest tube, if used, has been removed, and prior to discharge from the
hospital, subjects will undergo a two hour stay in a hypobaric chamber. In the first phase
of the study, they will undergo a two hour stay in a hypobaric chamber at a barometric
pressure of 565mm Hg, simulating the change in pressure from Salt Lake City to a cruising
airliner. If subjects in the first phase do not suffer any adverse events, the investigators
will proceed with the second phase. In the second phase of the study, subjects will undergo
a two hour stay in the hypobaric chamber at a barometric pressure of 471mm Hg, simulating
the change in pressure from sea level to a cruising airliner. Prior to the hypobaric
exposure, and at the conclusion of the two hours under hypobaric conditions, single view
chest radiographs will be performed.
pneumothorax that has been treated. Treatment for pneumothorax may consist of high-flow
oxygen therapy in the case of very small or "occult" pneumothorax, or tube thoracostomy
("chest tube") in the case of larger pneumothorax. Treatment for pneumothorax will be at
the discretion of the attending trauma surgeon. Once the pneumothorax has radiographically
resolved, the chest tube, if used, has been removed, and prior to discharge from the
hospital, subjects will undergo a two hour stay in a hypobaric chamber. In the first phase
of the study, they will undergo a two hour stay in a hypobaric chamber at a barometric
pressure of 565mm Hg, simulating the change in pressure from Salt Lake City to a cruising
airliner. If subjects in the first phase do not suffer any adverse events, the investigators
will proceed with the second phase. In the second phase of the study, subjects will undergo
a two hour stay in the hypobaric chamber at a barometric pressure of 471mm Hg, simulating
the change in pressure from sea level to a cruising airliner. Prior to the hypobaric
exposure, and at the conclusion of the two hours under hypobaric conditions, single view
chest radiographs will be performed.
Inclusion Criteria:
1. Inpatient status on trauma surgery service
2. An established diagnosis of pneumothorax with a traumatic etiology (patients with
iatrogenic pneumothorax from attempted central venous line placement will be
considered to have a traumatic etiology)
3. Age ≥ 18 at the time of injury
Exclusion Criteria:
1. Pregnancy
2. Unable to give informed consent
3. Pneumothorax which does not satisfactorily resolve after treatment with tube
thoracostomy and requires operative intervention such as video assisted thoracoscopic
surgery (VATS) or thoracotomy
4. Pneumothorax requiring tube thoracostomy where the tube has been removed for < 4 or >
48 hours
5. Head injury with GCS < 15 at time of evaluation for study
6. Other injuries or conditions which would preclude participant's ability to remain in
chamber for two hours
7. NYHA class III or IV heart failure, active coronary artery disease, arrhythmias,
pacemakers, implantable cardiac defibrillator, pulmonary hypertension, claustrophobia
8. Severe obstructive or restrictive lung disease
9. Chronic hypoxemia requiring supplemental oxygen
10. Hypoxemia for any reason (pulmonary contusion, atelectasis, pneumonia, etc.)
requiring > 3 liters supplemental oxygen at the time of entry into the study
11. Inability to tolerate the confines of the chamber
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