{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:42:44Z","timestamp":1777448564918,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T00:00:00Z","timestamp":1669766400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Observative management of small traumatic pneumothoraces (PTX) has been shown to decrease chest tube utilization in non-mechanically ventilated patients without compromising outcomes. This approach could be used in mechanically ventilated (MV) patients, though many feel these patients are at increased risk of observation failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single center retrospective study of all adults undergoing observation of a computed tomography (CT) diagnosed PTX from 2015-2019. Patients with chest tube placement within 4-hours of arrival, concurrent hemothorax, or death within 24-hours were excluded. Observation failure was defined as chest tube placement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 340 patients, 64 were on MV. The groups were of similar age, BMI, underlying pulmonary comorbidities, and PTX size (10.1\u00a0mm vs 8.8\u00a0mm, P = .20). The MV group was more severely injured (ISS [25+] [60.9% vs 11.2%, P &lt; .001]). There was no difference in observation failure rates by MV status overall (6.3% vs 5.1%, P = .75) or by PTX size (&lt;15\u00a0mm [5% vs 2.2%, P = .37], &lt;20\u00a0mm [4.8% vs 3.1%, P = .45], &lt;25\u00a0mm [4.8% vs 4.1%, P = .73], &lt;30\u00a0mm [4.8% vs 4.1%, P = .73], &lt;35\u00a0mm [4.8% vs 4.7%, P = 1.00]). MV was not an independent predictor of observation failure on multivariable analysis (OR .64, 95% CI .18-2.20), though PTX size was (OR 1.11, 95% CI 1.05-1.17). When comparing those who failed vs those who did not, the only difference was PTX size (9.34\u00a0mm vs 19.41\u00a0mm, P &lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MV is not an independent predictor of PTX observation failure. While PTX size appears to play a role, further studies are needed to outline safe parameters for observation in those undergoing MV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348221142583","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T09:37:35Z","timestamp":1669801055000},"page":"5246-5252","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Mechanical Ventilation Does Not Predict Pneumothorax Observation Failure in the Severely Injured"],"prefix":"10.1177","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3276-5230","authenticated-orcid":false,"given":"Courtney J.","family":"Pokrzywa","sequence":"first","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Gomez","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Basil","family":"Karam","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"Iverson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Carver","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Milia","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"de Moya","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, 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