%0 Journal Article
%T Is massive hemothorax still an absolute indication for operation in blunt trauma?
%J Injury
%D 2020
%A Huang, Jen-Fu
%A Hsu, Chih-Po
%A Fu, Chih-Yuan
%A Ou Yang, Chun-Hsiang
%A Cheng, Chi-Tung
%A Liao, Chien-Hung
%A Kuo, I.-Ming
%A Hsieh, Chi-Hsun
%V ePub
%N ePub
%P ePub-ePub
%X BACKGROUND: Surgery is usually suggested to treat massive haemothorax (MHT). The MHT criteria are based on penetrating trauma observations in military scenarios; the  need for surgery in blunt trauma patients remains questionable. This study aimed to  determine the characteristics of blunt trauma patients with MHT who required  surgery. <br><br>METHODS: Patients who presented to the emergency department (ED) with  traumatic haemothorax or pneumothorax, heart and lung injuries, and thoracic blood  vessel injuries from Jan 1, 2014, to Dec 31, 2018, were reviewed. The inclusion  criterion was a chest tube drainage amount that met the MHT criteria. Therapeutic  operations were defined as those involving surgical haemostasis; otherwise,  operations were considered non-therapeutic. The non-therapeutic operation group  included the patients who received nonoperative management. The characteristics of  the therapeutic and non-therapeutic operation groups were compared. <br><br>RESULTS:  Forty-four patients were enroled in the study. Six patients received conservative  treatment and were discharged uneventfully. Eleven patients underwent  non-therapeutic operations. The patients with surgical bleeding had a high pulse  rate (125.0 (111.0, 135.0) vs. 116.0 (84.0, 121.0) bpm, p = 0.013); low systolic  blood pressure (SBP) after resuscitation (106.0 (84.0, 127.0) vs. 121.0 (116.0,  134.0) mmHg, p = 0.040); low pH (7.2 (7.2, 7.3) vs. 7.4 (7.3, 7.4), p = 0.002); and  low bicarbonate (17.8 (14.6, 21.5) vs. 21.4 (17.0, 21.5) mEq/L, p = 0.038), low base  excess (-9.1 (-13.4, -4.5) vs. -3.8 (-10.1, -0.7), p = 0.028), and high lactate (5.7  (3.3, 7.8) vs. 1.8 (1.7, 2.8) mmol/L, p = 0.002) levels. <br><br>CONCLUSION: Conservative  treatment could be performed selectively in patients with MHT. Lactate could be a  predictor of the need for surgical intervention in blunt trauma patients with MHT.<p /> <p>Language: en</p>
%G en
%I Elsevier Publishing
%@ 0020-1383
%U http://dx.doi.org/10.1016/j.injury.2020.12.016