Prospective Evaluation of 14F Thal Tube vs 28 French Chest Tube for Hemothorax and Use of Maximum Barrier Precautions
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Infectious Disease, Hospital |
| Therapuetic Areas: | Immunology / Infectious Diseases, Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/2/2019 |
| Start Date: | May 8, 2017 |
| End Date: | August 31, 2020 |
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.
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.
Inclusion Criteria:
- The patient is admitted to the trauma service.
- The patient has a hemothorax and/or or hemopneumothorax, requiring thoracostomy tube
placement.
- Thoracostomy tube placement is able to be performed or witnessed by an investigator
listed on the study.
- The patient has not had a chest tube in the past year.
- The patient is >18 years of age.
- In the event the patient is decisionally impaired, consent will be obtained from the
individual's legally authorized representative (LAR) or from the individual's
healthcare power of attorney (HPA).
- In the instance of reversible impairment, initial consent would be obtained from the
LAR/HPA and the patient will be approached for consent once he/she is deemed mentally
competent by the care provider.
Exclusion Criteria:
- The patient is incarcerated
- The patient is known to be pregnant
- The patient is < 18 years of age
- The patient is hemodynamically unstable, requiring emergent chest tube placement (in
<10 minutes from evaluation).
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