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The frequency of reexpansion pulmonary edema after trocar and hemostat assisted thoracostomy in patients with spontaneous pneumothorax

Yonsei Medical Journal, 2013, 54(1), , pp.166-171 [Peer Reviewed Journal]

Copyright: Yonsei University College of Medicine 2013 2013 ;ISSN: 0513-5796 ;EISSN: 1976-2437 ;DOI: 10.3349/ymj.2013.54.1.166 ;PMID: 23225814

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  • Title:
    The frequency of reexpansion pulmonary edema after trocar and hemostat assisted thoracostomy in patients with spontaneous pneumothorax
  • Author: Cha, Kyoung Chul ; Kim, Hyun ; Ji, Ho Jin ; Kwon, Woo Cheol ; Shin, Hyung Jin ; Cha, Yong Sung ; Lee, Kang Hyun ; Hwang, Sung Oh ; Lee, Christopher C ; Singer, Adam J
  • Subjects: Adult ; Female ; Hemostatic Techniques ; Humans ; Male ; Multivariate Analysis ; Original ; Pneumothorax - complications ; Pneumothorax - surgery ; Prospective Studies ; Pulmonary Edema - diagnosis ; Pulmonary Edema - etiology ; Pulmonary Edema - surgery ; Risk Factors ; Surgical Instruments ; Thoracostomy - adverse effects ; Thoracostomy - methods ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult ; 의학일반
  • Is Part Of: Yonsei Medical Journal, 2013, 54(1), , pp.166-171
  • Description: Several risk factors for development of reexpansion pulmonary edema (REPE) after drainage of pneumothoraces have been reported, but the association between the method of thoracostomy and the development of REPE is unknown. The aim of this study was to compare the frequency of REPE after treatment of spontaneous pneumothorax with trocar or hemostat assisted closed thoracostomy. We performed a prospective, observational study including 173 patients with spontaneous pneumothorax who visited the emergency department from January 2007 to December 2008. In 2007, patients were treated with hemostat-assisted drainage, whereas patients in 2008 were treated with trocar-assisted drainage. The main outcome was the development of REPE, determined by computed tomography of the chest 8 hours after closed thoracostomy. Outcomes in both groups were compared using univariate and multivariate analyses. Ninety-two patients were included, 48 (42 males) of which underwent hemostat-assisted drainage and 44 (41 males) underwent trocar-assisted drainage. The groups were similar in mean age (24 ± 10 vs. 26 ± 14 respectively). The frequencies of REPE after hemostat- and trocar-assisted drainage were 63% (30 patients) and 86% (38 patients) respectively (p=0.009). In multivariate analysis, trocar-assisted drainage was the major contributing factor for developing REPE (odds ratio=5.7, 95% confidence interval, 1.5-21). Age, gender, size of pneumothorax, symptom duration and laboratory results were similar between the groups. Closed thoracostomy using a trocar is associated with an increased risk of REPE compared with hemostat- assisted drainage in patients with spontaneous pneumothorax.
  • Publisher: Korea (South): Yonsei University College of Medicine
  • Language: English
  • Identifier: ISSN: 0513-5796
    EISSN: 1976-2437
    DOI: 10.3349/ymj.2013.54.1.166
    PMID: 23225814
  • Source: Open Access: DOAJ Directory of Open Access Journals
    Open Access: PubMed Central
    KoreaMed Synapse(OpenAccess)
    GFMER Free Medical Journals
    MEDLINE
    KoreaMed Open Access
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