{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T02:22:14Z","timestamp":1792894934605,"version":"4.5.0"},"reference-count":20,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T00:00:00Z","timestamp":1709164800000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007928","name":"Perelman School of Medicine, University of Pennsylvania","doi-asserted-by":"publisher","award":["Bach Fund"],"award-info":[{"award-number":["Bach Fund"]}],"id":[{"id":"10.13039\/100007928","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2024,1,16]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Percutaneously placed small-bore (14 Fr) catheters and pleural lavage have emerged independently as innovative approaches to hemothorax management. This report describes techniques for combining percutaneous thoracostomy with pleural lavage and presents results from a performance improvement series of patients managed with percutaneous thoracostomy with immediate lavage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective performance improvement series of patients treated at a level 1 trauma center with percutaneous thoracostomy and immediate lavage between April 2021 and May 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Percutaneous thoracostomy with immediate lavage was used to treat nine hemodynamically normal patients with acute hemothorax. Injuries included both blunt and penetrating mechanisms. 56% of patients presented immediately after injury, and 44% presented in a delayed fashion ranging from 2 to 26 days after injury. Median length of stay was 6 days (IQR 6, 9). Seven patients were discharged home in stable condition, one was discharged to an acute rehabilitation facility, and one was discharged to a skilled nursing facility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Percutaneous thoracostomy with pleural lavage is clinically feasible and effective and warrants further evaluation with a multicenter clinical trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Therapeutic\/care management, level V.<\/jats:p><\/jats:sec>","DOI":"10.1136\/tsaco-2023-001298","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T03:30:21Z","timestamp":1709263821000},"page":"e001298","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiative"],"prefix":"10.1136","volume":"9","author":[{"given":"Nathaniel","family":"McLauchlan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl A","family":"Beyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha M","family":"Brinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M","family":"Joergensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Yelon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6566-1833","authenticated-orcid":false,"given":"Ryan Peter","family":"Dumas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A","family":"Vella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2969-9316","authenticated-orcid":false,"given":"Jeremy W","family":"Cannon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,2,29]]},"reference":[{"key":"2025010104401297000_9.1.e001298.1","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.thorsurg.2012.10.003","article-title":"Hemothorax: etiology, diagnosis, and management","volume":"23","author":"Broderick","year":"2013","journal-title":"Thorac Surg Clin"},{"key":"2025010104401297000_9.1.e001298.2","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1097\/TA.0000000000002881","article-title":"Predictors of retained Hemothorax in trauma: results of an Eastern Association for the surgery of trauma multi-institutional trial","volume":"89","author":"Prakash","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"key":"2025010104401297000_9.1.e001298.3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/TA.0b013e318242e368","article-title":"Management of post-traumatic retained Hemothorax: a prospective, observational, multicenter AAST study","volume":"72","author":"DuBose","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"key":"2025010104401297000_9.1.e001298.4","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31825c1616"},{"key":"2025010104401297000_9.1.e001298.5","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/j.surg.2023.06.030","article-title":"Predictors of initial management failure in traumatic Hemothorax: a prospective multicenter cohort analysis","volume":"174","author":"Beyer","year":"2023","journal-title":"Surgery"},{"key":"2025010104401297000_9.1.e001298.6","unstructured":"American College of Surgeons . Advanced Trauma Life Support (ATLS) Student Course Manual, 9th ed; 2013."},{"key":"2025010104401297000_9.1.e001298.7","unstructured":"American College of Surgeons . Advanced Trauma Life Support (ATLS\u00ae) Student Course Manual, 10th ed; 2018."},{"key":"2025010104401297000_9.1.e001298.8","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1097\/TA.0000000000001700","article-title":"Thoracic irrigation prevents retained Hemothorax: a prospective propensity scored analysis","volume":"83","author":"Kugler","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"key":"2025010104401297000_9.1.e001298.9","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003180"},{"key":"2025010104401297000_9.1.e001298.10","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/j.amjsurg.2020.11.032","article-title":"Management of simple and retained Hemothorax: a practice management guideline from the Eastern Association for the surgery of trauma: Hemothorax management guideline","volume":"221","author":"Patel","year":"2021","journal-title":"Am J Surg"},{"key":"2025010104401297000_9.1.e001298.11","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1002\/bjs.9377","article-title":"Randomized clinical trial of Pigtail catheter versus chest tube in injured patients with uncomplicated traumatic pneumothorax","volume":"101","author":"Kulvatunyou","year":"2014","journal-title":"Br J Surg"},{"key":"2025010104401297000_9.1.e001298.12","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1631\/jzus.B1100161","article-title":"Management of traumatic Hemothorax by closed thoracic drainage using a central venous catheter","volume":"13","author":"Yi","year":"2012","journal-title":"J Zhejiang Univ Sci B"},{"key":"2025010104401297000_9.1.e001298.13","unstructured":"de\u00a0Moya M . Western trauma association traumatic Hemothorax algorithm. Available: https:\/\/www.westerntrauma.org\/wp-content\/uploads\/2021\/03\/b21435d708c8497f9a77cf92125c319b1.pdf"},{"key":"2025010104401297000_9.1.e001298.14","doi-asserted-by":"crossref","unstructured":"Beyer CA , Mclauchlan NR , Cannon JW . Thoracic lavage for traumatic Hemothorax. [In Press]. JAMA Surg 2023.","DOI":"10.1001\/jamasurg.2023.3822"},{"key":"2025010104401297000_9.1.e001298.15","doi-asserted-by":"crossref","DOI":"10.1136\/tsaco-2022-001050","article-title":"Open versus percutaneous tube thoracostomy with and without thoracic lavage for traumatic Hemothorax: a novel randomized controlled simulation trial","volume":"8","author":"McLauchlan","year":"2023","journal-title":"Trauma Surg Acute Care Open"},{"key":"2025010104401297000_9.1.e001298.16","doi-asserted-by":"publisher","DOI":"10.1097\/00005382-199904000-00011"},{"key":"2025010104401297000_9.1.e001298.17","doi-asserted-by":"crossref","DOI":"10.1136\/tsaco-2022-000886","article-title":"Antibiotic prophylaxis for tube thoracostomy placement in trauma: a practice management guideline from the Eastern Association for the surgery of trauma","volume":"7","author":"Freeman","year":"2022","journal-title":"Trauma Surg Acute Care Open"},{"key":"2025010104401297000_9.1.e001298.18","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.thorsurg.2016.08.005","article-title":"Modern techniques to insert chest drains","volume":"27","author":"McElnay","year":"2017","journal-title":"Thorac Surg Clin"},{"key":"2025010104401297000_9.1.e001298.19","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.117200"},{"key":"2025010104401297000_9.1.e001298.20","doi-asserted-by":"crossref","first-page":"ii61","DOI":"10.1136\/thx.2010.137026","article-title":"Pleural procedures and thoracic ultrasound: British Thoracic society pleural disease guideline 2010","volume":"65 Suppl 2","author":"Havelock","year":"2010","journal-title":"Thorax"}],"container-title":["Trauma Surgery &amp; Acute Care Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tsaco-2023-001298","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T12:40:35Z","timestamp":1735735235000},"score":1,"resource":{"primary":{"URL":"https:\/\/tsaco.bmj.com\/lookup\/doi\/10.1136\/tsaco-2023-001298"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,2,29]]},"published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1136\/tsaco-2023-001298"],"URL":"https:\/\/doi.org\/10.1136\/tsaco-2023-001298","relation":{},"ISSN":["2397-5776"],"issn-type":[{"value":"2397-5776","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]}}}