Traumatic Pneumothorax
Conditions
Brief summary
The purpose of this pilot study is to determine whether chest tube suction duration, 24 hours vs 48 hours, prior to water seal affects outcome and length of stay after placement for traumatic pneumothorax.
Interventions
PROCEDUREChest tube suction
The chest tubes will be inserted using our institutional standard chest tube insertion tray. The chest tubes used will be our institutional standard and will range from 14 to 32Fr in size. After chest tube placement, an Atrium Oasis Dry Suction Water Seal Chest Drain (Getinge USA Sales, LLC) will be used.
Sponsors
University of Rochester
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Trauma service consult/patient * Traumatic pneumothorax with chest tube placed within 0-24 hours of presentation and confirmation of adequate position * Age \>18 * Blunt or penetrating mechanism * Chest tubes sizes 14 to 32Fr * Chest tubes placed by residents on the trauma surgery service supervised by attending trauma surgeons or placed by the attending surgeon themselves * Presence of single chest tube in one or both pleural cavities (single unilateral or bilateral tubes) * Subjects with decision making capacity (DMC) who are able to provide written consent. DMC will be determined by the consenting physician through a teach back mechanism. Subjects must demonstrate understanding of the situation, appreciation of the consequences of their decision, reasoning of their thought process, and be able to communicate their wishes.
Exclusion criteria
* Age \<18 * Pregnant patients * Prisoners * Mechanically ventilated in ICU for more than 24 hours while chest tube in place * Chest tubes placed as part of, or present during, a thoracic operation * History of surgery involving pleural cavity ipsilateral to chest tube * Subjects with more than one chest tube on the ipsilateral side at any time prior to study chest tube removal * Subjects with chylothorax or empyema * Subjects with chest tubes that are withdrawn or removed unintentionally * Subjects with known or suspected bronchial injury * Subjects with bullous emphysema.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Chest tube dwell time | up to 1 month | Total time that chest tube is in place from insertion to removal |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants with reaccumulation of pneumothorax | up to 3 days | After transition to water seal and stopping suction, incidence of reaccumulation of pneumothorax requiring suction or replacement of chest tube. |
| Number of participants with at least one pulmonary complications | up to 1 week | Pulmonary complications are defined as increased oxygen requirements, shortness of breath or unplanned intubations following placement to suction. |
| Readmission to hospital | 30 days | Number of participants readmitted to the hospital within 30 days |
| Transfer to ICU | up to 1 week | Number of participants with an unplanned transfer to the intensive care unit |
| Median length of stay | Up to 1 year | Median length of stay in the hospital after chest tube placement |
Countries
United States
Outcome results
None listed