![]() ![]() We hypothesize that increasing the chest tube size will not result in a proportional increase in flowrate as predicted by the Hagen–Poiseuille equation, due to constant resistance in the chest tube circuit. 6, 7 No studies exist that simulate chest drainage in a controlled setting to measure flow through a chest tube system, and whether increases in chest tube size increase drainage as predicted. Previous studies have sought to determine whether chest tube size relates to drainage efficacy, postprocedure complications or pain management. To adequately drain a hemothorax, most chest tubes are sized and positioned to adequately drain accumulated blood. While larger tubes will certainly evacuate blood more rapidly, larger tubes are also more challenging to place and may cause more pain for the patient. ![]() For patients with more chronic conditions, this can be expanded to any fluid or material, which might collect in the chest. 4, 5 For trauma patients suffering acute injury, the material drained is almost exclusively blood, air, or both. The placement and management of a chest tube is a core tenet of surgical training and is often one of the earliest procedures learned in surgery residency.Ī common clinical decision is what chest tube size to place to sufficiently drain the pleural space.1, 2, 3 The American College of Surgeons ATLS (Advanced Trauma Life Support) curriculum recommends 36–40F tubes (version 9) or 28–32F tubes (version 10) for the treatment of hemothorax. Thus, a chest tube is one of the most common procedures in trauma patients. However, when intervention is necessary, the most patients require drainage of the pleural space through a tube thoracostomy. Most patients suffering chest trauma can be managed with supportive care only, avoiding procedures. ![]() Chest trauma is commonly managed in trauma centers, from both blunt and penetrating mechanisms. ![]()
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