title: Initial suction evacuation of traumatic hemothoraces: a novel approach to decreasing chest tube duration and complications.
abstract: Between 2 and 4.4 per cent of all patients with trauma chest tubes develop retained hemothoraces. Retained hemothoraces prolong chest tube duration and hospital length of stay, and increase infectious complications like empyema. Early surgical drainage of retained hemothoraces has been  shown to decrease complications and reduce hospital length of stay. However, the high resource and expertise requirement may limit the widespread applicability of surgical drainage. We present the results of a relatively simple and novel intervention for traumatic hemothoraces undertaken by  our faculty to shorten chest tube duration and prevent empyema formation. At our Level I trauma center, 10 trauma patients underwent initial suction evacuation of their traumatic hemothoraces using a sterile suction catheter before chest tube placement. Compared with propensity matched controls,  patients that underwent initial suction evacuation experienced significantly shorter chest tube duration (4.2 ± 1.9 vs 5.8 ± 2.3 days, P = 0.04). Also, in this population, there was an 8.2 per cent decrease in the number of patients that developed empyema or required  additional drainage. Our study suggests that initial suction evacuation of traumatic hemothoraces is an effective and relatively easy intervention that reduces the duration of chest tube therapy, empyema formation, and the need for additional surgical intervention.
authors.affiliation: Virginia Commonwealth University Medical Center, Richmond, Virginia, USA. rajesh.x.ramanathan@gmail.com
authors.forename: Rajesh
authors.initials: R
authors.lastname: Ramanathan
authors.forename: Luke G
authors.initials: LG
authors.lastname: Wolfe
authors.forename: Therese M
authors.initials: TM
authors.lastname: Duane
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015505:Chest Tubes; D004653:Empyema / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006491:Hemothorax / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013396:Suction / Q000295:instrumentation / Q000379:methods*; D013898:Thoracic Injuries / Q000150:complications / Q000628:therapy*; D020775:Thoracic Surgery, Video-Assisted; D013997:Time Factors; D014193:Trauma Centers; D014768:Virginia / Q000453:epidemiology