Hemothorax Medication

  • Author: Mary C Mancini, MD, PhD; Chief Editor: Jeffrey C Milliken, MD   more...
 
Updated: Sep 26, 2011
 
 

Medication Summary

No data support routine antibiotic coverage of chest tubes in patients with hemothorax. Pain control may require intravenous opioid analgesic agents, intracostal nerve blocks around the chest tube site, or both. Low suction should be used on the chest tube.

 
Contributor Information and Disclosures
Author

Mary C Mancini, MD, PhD  Professor and Chief of Cardiothoracic Surgery, Department of Surgery, Louisiana State University School of Medicine in Shreveport

Mary C Mancini, MD, PhD is a member of the following medical societies: American Association for Thoracic Surgery, American College of Surgeons, American Surgical Association, Phi Beta Kappa, Society of Thoracic Surgeons, and Southern Surgical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Thomas Scanlin, MD  Chief, Division of Pulmonary Medicine and Cystic Fibrosis Center, Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School

Thomas Scanlin, MD is a member of the following medical societies: American Association for the Advancement of Science, American Society for Biochemistry and Molecular Biology, American Thoracic Society, Society for Pediatric Research, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Denise Serebrisky, MD  Assistant Professor, Department of Pediatrics, Albert Einstein College of Medicine; Director, Division of Pulmonary Medicine, Lewis M Fraad Department of Pediatrics, Jacobi Medical Center; Director, Jacobi Asthma and Allergy Center for Children

Denise Serebrisky, MD is a member of the following medical societies: American Thoracic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Charles Callahan, DO  Professor, Deputy Chief of Clinical Services, Walter Reed Army Medical Center

Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, Association of Military Surgeons of the US, and Christian Medical & Dental Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Shreekanth V Karwande, MBBS  Chair, Professor, Department of Surgery, Division of Cardiothoracic Surgery, University of Utah School of Medicine and Medical Center

Shreekanth V Karwande, MBBS is a member of the following medical societies: American Association for Thoracic Surgery, American College of Chest Physicians, American College of Surgeons, American Heart Association, Society of Critical Care Medicine, Society of Thoracic Surgeons, and Western Thoracic Surgical Association

Disclosure: Nothing to disclose.

Michael R Bye, MD  Professor of Clinical Pediatrics, Division of Pulmonary Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, Pediatric Pulmonary Medicine, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center

Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

Chief Editor

Jeffrey C Milliken, MD  Chief, Division of Cardiothoracic Surgery, University of California at Irvine Medical Center; Clinical Professor, Department of Surgery, University of California, Irvine, School of Medicine

Jeffrey C Milliken, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Thoracic Surgery, American College of Cardiology, American College of Chest Physicians, American College of Surgeons, American Heart Association, American Society for Artificial Internal Organs, California Medical Association, International Society for Heart and Lung Transplantation, Phi Beta Kappa, Society of Thoracic Surgeons, Southwest Oncology Group, and Western Surgical Association

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Jane M Eggerstedt, MD, and Allen Fagenholz, MD, to the development and writing of the source articles.

References
  1. Tatebe S, Kanazawa H, Yamazaki Y, Aoki E, Sakurai Y. Spontaneous hemopneumothorax. Ann Thorac Surg. Oct 1996;62(4):1011-5. [Medline].

  2. Rusch VW, Ginsberg RJ. Chest wall, pleura, lung and mediastinum. In: Schwartz SI, ed. Principles of Surgery. 7th ed. New York, NY: McGraw-Hill; 1999:667-790.

  3. Clark JM, Harryman DT 2nd. Tendons, ligaments, and capsule of the rotator cuff. Gross and microscopic anatomy. J Bone Joint Surg Am. Jun 1992;74(5):713-25. [Medline].

  4. Johnson EM, Saltzman DA, Suh G, Dahms RA, Leonard AS. Complications and risks of central venous catheter placement in children. Surgery. Nov 1998;124(5):911-6. [Medline].

  5. Waddington MS, Mullins GC. Early complication of pediatric central venous cannulation. Paediatr Anaesth. Nov 2005;15(11):1001-5. [Medline].

  6. Lesher AP, Kratz JM, Smith CD. Removal of embedded central venous catheters. J Pediatr Surg. Jun 2008;43(6):1030-4. [Medline].

  7. Nakayama DK, Ramenofsky ML, Rowe MI. Chest injuries in childhood. Ann Surg. Dec 1989;210(6):770-5. [Medline]. [Full Text].

  8. Sharma OP, Hagler S, Oswanski MF. Prevalence of delayed hemothorax in blunt thoracic trauma. Am Surg. Jun 2005;71(6):481-6. [Medline].

  9. Cottin V, Chinet T, Lavolé A, Corre R, Marchand E, Reynaud-Gaubert M, et al. Pulmonary arteriovenous malformations in hereditary hemorrhagic telangiectasia: a series of 126 patients. Medicine (Baltimore). Jan 2007;86(1):1-17. [Medline].

  10. Sinniah D, Nagalingam I. Hemothorax in the newborn. Clin Pediatr (Phila). Feb 1972;11(2):84-5. [Medline].

  11. Huybrechts S, Wojciechowski M, Poot S, Van Reempts P, Ramet J. Hemothorax as presentation of late vitamin-K-deficient bleeding in a 1-month-old infant with homozygous alpha-1-antitrypsin deficiency. Eur J Pediatr. Oct 2007;166(10):1081-2. [Medline].

  12. Hammoudeh M, Qaddoumi NK. Pleural haemorrhage in Henoch Schonlein purpura. Clin Rheumatol. Dec 1993;12(4):538-9. [Medline].

  13. Laberge JM, Puligandla P, Flageole H. Asymptomatic congenital lung malformations. Semin Pediatr Surg. Feb 2005;14(1):16-33. [Medline].

  14. Vaziri M, Mehrazma M. Massive spontaneous hemothorax associated with Von Recklinghausen's disease. Ann Thorac Surg. Oct 2006;82(4):1500-1. [Medline].

  15. Propper RA, Young LW, Wood BP. Hemothorax as a complication of costal cartilaginous exostoses. Pediatr Radiol. Apr 1980;9(3):135-7. [Medline].

  16. Tomares SM, Jabra AA, Conrad CK, Beauchamp N, Phoon CK, Carroll JL. Hemothorax in a child as a result of costal exostosis. Pediatrics. Mar 1994;93(3):523-5. [Medline].

  17. Jin W, Hyun SY, Ryoo E, Lim YS, Kim JK. Costal osteochondroma presenting as haemothorax and diaphragmatic laceration. Pediatr Radiol. Jul 2005;35(7):706-9. [Medline].

  18. Cowles RA, Rowe DH, Arkovitz MS. Hereditary multiple exostoses of the ribs: an unusual cause of hemothorax and pericardial effusion. J Pediatr Surg. Jul 2005;40(7):1197-200. [Medline].

  19. Osawa H, Yoshii S, Takahashi W, Hosaka S, Ishikawa N, Mizutani E, et al. Hemorrhagic shock due to intrathoracic rupture of an osteosarcoma of the rib. Ann Thorac Cardiovasc Surg. Aug 2001;7(4):232-4. [Medline].

  20. Kim ES, Kang JY, Pyo CH, Jeon EY, Lee WB. 12-year experience of spontaneous hemopneumothorax. Ann Thorac Cardiovasc Surg. Jun 2008;14(3):149-53. [Medline].

  21. Richardson JD, Miller FB, Carrillo EH, Spain DA. Complex thoracic injuries. Surg Clin North Am. Aug 1996;76(4):725-48. [Medline].

  22. Peclet MH, Newman KD, Eichelberger MR, Gotschall CS, Garcia VF, Bowman LM. Thoracic trauma in children: an indicator of increased mortality. J Pediatr Surg. Sep 1990;25(9):961-5; discussion 965-6. [Medline].

  23. Inci I, Ozcelik C, Nizam O, Eren N, Ozgen G. Penetrating chest injuries in children: a review of 94 cases. J Pediatr Surg. May 1996;31(5):673-6. [Medline].

  24. Bohosiewicz J, Kudela G, Koszutski T. Results of Nuss procedures for the correction of pectus excavatum. Eur J Pediatr Surg. Feb 2005;15(1):6-10. [Medline].

  25. Issaivanan M, Baranwal P, Abrol S, Bajwa G, Baldauf M, Shukla M. Spontaneous hemopneumothorax in children: case report and review of literature. Pediatrics. Oct 2006;118(4):e1268-70. [Medline].

  26. Parry GW, Morgan WE, Salama FD. Management of haemothorax. Ann R Coll Surg Engl. Jul 1996;78(4):325-6. [Medline]. [Full Text].

  27. Miller LA. Chest wall, lung, and pleural space trauma. Radiol Clin North Am. Mar 2006;44(2):213-24, viii. [Medline].

  28. Mandavia DP, Joseph A. Bedside echocardiography in chest trauma. Emerg Med Clin North Am. Aug 2004;22(3):601-19. [Medline].

  29. Trupka A, Waydhas C, Hallfeldt KK, Nast-Kolb D, Pfeifer KJ, Schweiberer L. Value of thoracic computed tomography in the first assessment of severely injured patients with blunt chest trauma: results of a prospective study. J Trauma. Sep 1997;43(3):405-11; discussion 411-2. [Medline].

  30. Moore MA, Wallace EC, Westra SJ. The imaging of paediatric thoracic trauma. Pediatr Radiol. May 2009;39(5):485-96. [Medline].

  31. Chang YT, Dai ZK, Kao EL, Chuang HY, Cheng YJ, Chou SH, et al. Early video-assisted thoracic surgery for primary spontaneous hemopneumothorax. World J Surg. Jan 2007;31(1):19-25. [Medline].

  32. Heniford BT, Carrillo EH, Spain DA, Sosa JL, Fulton RL, Richardson JD. The role of thoracoscopy in the management of retained thoracic collections after trauma. Ann Thorac Surg. Apr 1997;63(4):940-3. [Medline].

  33. Liu DW, Liu HP, Lin PJ, Chang CH. Video-assisted thoracic surgery in treatment of chest trauma. J Trauma. Apr 1997;42(4):670-4. [Medline].

  34. Mancini M, Smith LM, Nein A, Buechter KJ. Early evacuation of clotted blood in hemothorax using thoracoscopy: case reports. J Trauma. Jan 1993;34(1):144-7. [Medline].

  35. Meyer DM, Jessen ME, Wait MA, Estrera AS. Early evacuation of traumatic retained hemothoraces using thoracoscopy: a prospective, randomized trial. Ann Thorac Surg. Nov 1997;64(5):1396-400; discussion 1400-1. [Medline].

  36. Navsaria PH, Vogel RJ, Nicol AJ. Thoracoscopic evacuation of retained posttraumatic hemothorax. Ann Thorac Surg. Jul 2004;78(1):282-5; discussion 285-6. [Medline].

  37. Inci I, Ozçelik C, Ulkü R, Tuna A, Eren N. Intrapleural fibrinolytic treatment of traumatic clotted hemothorax. Chest. Jul 1998;114(1):160-5. [Medline].

Previous
Next
 
Left hemothorax in a patient with rib fractures.
Upright posteroanterior (PA) chest radiograph of a patient with right hemothorax.
Contrast enhanced CT scan of a patient with right hemothorax.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.