| Treatment of haemothorax. | |
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MedLine Citation:
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PMID: 20817498 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Haemothorax is a problem commonly encountered in medical practice and is most frequently related to open or closed chest trauma or to invasive procedures of the chest. Spontaneous haemothorax is less common and can have various causes, such as the use of anticoagulants, neoplasia, and rupture of pleural adhesions. Identification by radiography and thoracentesis is indicated and treatment of the underlying trauma should start immediately. After insertion of a large chest tube, antibiotic prophylaxis in trauma patients should be administered for 24 h. Further treatment depends on the haemodynamic stability of the patient, the volume of evacuated blood and the occurrence of persistent blood loss. Surgical exploration by VATS or thoracotomy is necessary if >1.500 ml of blood has accumulated and/or an ongoing production of >200 ml of blood per hour is observed. If the haemorrhage is less severe, careful investigation into the underlying cause must be performed and blood should be evacuated by tube thoracostomy. If clotted blood retained in spite of tube thoracostomy, intrapleural fibrinolytic therapy can be applied to breakdown clots and adhesions. If conservative treatment is insufficient, a surgical approach with VATS or thoracotomy is indicated to prevent subsequent complications. |
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Authors:
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Wim G Boersma; Jos A Stigt; Hans J M Smit |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Respiratory medicine Volume: 104 ISSN: 1532-3064 ISO Abbreviation: Respir Med Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-09-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8908438 Medline TA: Respir Med Country: England |
Other Details:
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Languages: eng Pagination: 1583-7 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Pulmonary Diseases, Medical Centre Alkmaar, Alkmaar, The Netherlands. w.boersma@mca.nl |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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