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Chest Tube Placement in Mechanically Ventilated Trauma Patients: Differences between Computed Tomography-Based Indication and Clinical Decision

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Chest Tube Placement in Mechanically Ventilated Trauma Patients: Differences between Computed Tomography-Based Indication and Clinical Decision. / Struck, Manuel Florian; Kleber, Christian; Ewens, Sebastian; Ebel, Sebastian; Kirsten, Holger; Krämer, Sebastian; Schob, Stefan; Osterhoff, Georg; Girrbach, Felix; Hilbert-Carius, Peter; Ondruschka, Benjamin; Hempel, Gunther.

in: J CLIN MED, Jahrgang 11, Nr. 14, 4043, 13.07.2022.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Struck, MF, Kleber, C, Ewens, S, Ebel, S, Kirsten, H, Krämer, S, Schob, S, Osterhoff, G, Girrbach, F, Hilbert-Carius, P, Ondruschka, B & Hempel, G 2022, 'Chest Tube Placement in Mechanically Ventilated Trauma Patients: Differences between Computed Tomography-Based Indication and Clinical Decision', J CLIN MED, Jg. 11, Nr. 14, 4043. https://doi.org/10.3390/jcm11144043

APA

Struck, M. F., Kleber, C., Ewens, S., Ebel, S., Kirsten, H., Krämer, S., Schob, S., Osterhoff, G., Girrbach, F., Hilbert-Carius, P., Ondruschka, B., & Hempel, G. (2022). Chest Tube Placement in Mechanically Ventilated Trauma Patients: Differences between Computed Tomography-Based Indication and Clinical Decision. J CLIN MED, 11(14), [4043]. https://doi.org/10.3390/jcm11144043

Vancouver

Struck MF, Kleber C, Ewens S, Ebel S, Kirsten H, Krämer S et al. Chest Tube Placement in Mechanically Ventilated Trauma Patients: Differences between Computed Tomography-Based Indication and Clinical Decision. J CLIN MED. 2022 Jul 13;11(14). 4043. https://doi.org/10.3390/jcm11144043

Bibtex

@article{bacb5b2b6b2b48c58f4710708b4dfc0e,
title = "Chest Tube Placement in Mechanically Ventilated Trauma Patients: Differences between Computed Tomography-Based Indication and Clinical Decision",
abstract = "The rate of occult pneumothorax in intubated and mechanically ventilated trauma patients until initial computed tomography (CT) remains undetermined. The primary aims of this study were to analyze initial chest CTs with respect to the thoracic pathology of trauma, the clinical injury severity, and chest tube placement (CTP) before and after CT. In a single-center retrospective analysis of 616 intubated and mechanically ventilated adult patients admitted directly from the scene to the emergency department (ED), 224 underwent CTP (36%). Of these, 142 patients (62%) underwent CTP before CT, of which, 125 (88%) had significant chest injury on CT. Seventeen patients had minor or absent chest injuries, most of which were associated with transient or unrecognized tracheal tube malposition. After CT, CTP was performed in another 82 patients, of which, 56 (68.3%) had relevant pneumothorax and 26 had minor findings on CT. Sixty patients who had already undergone CTP before CT received another CTP after CT, of which, 15 (25%) had relevant pneumothorax and 45 (75%) had functionality issues or malposition requiring replacement. Nine patients showed small pneumothorax on CT, and did not undergo CTP (including four patients with CTP before CT). The physiological variables were unspecific, and the trauma scores were dependent on the CT findings for identifying patients at risk for CTP. In conclusion, the clinical decisions for CTP before CT are associated with relevant false-negative and false-positive cases. Clinical assessment and CT imaging, together, are important indicators for CTP decisions that cannot be achieved by using clinical assessment or CT alone.",
author = "Struck, {Manuel Florian} and Christian Kleber and Sebastian Ewens and Sebastian Ebel and Holger Kirsten and Sebastian Kr{\"a}mer and Stefan Schob and Georg Osterhoff and Felix Girrbach and Peter Hilbert-Carius and Benjamin Ondruschka and Gunther Hempel",
year = "2022",
month = jul,
day = "13",
doi = "10.3390/jcm11144043",
language = "English",
volume = "11",
journal = "J CLIN MED",
issn = "2077-0383",
publisher = "MDPI AG",
number = "14",

}

RIS

TY - JOUR

T1 - Chest Tube Placement in Mechanically Ventilated Trauma Patients: Differences between Computed Tomography-Based Indication and Clinical Decision

AU - Struck, Manuel Florian

AU - Kleber, Christian

AU - Ewens, Sebastian

AU - Ebel, Sebastian

AU - Kirsten, Holger

AU - Krämer, Sebastian

AU - Schob, Stefan

AU - Osterhoff, Georg

AU - Girrbach, Felix

AU - Hilbert-Carius, Peter

AU - Ondruschka, Benjamin

AU - Hempel, Gunther

PY - 2022/7/13

Y1 - 2022/7/13

N2 - The rate of occult pneumothorax in intubated and mechanically ventilated trauma patients until initial computed tomography (CT) remains undetermined. The primary aims of this study were to analyze initial chest CTs with respect to the thoracic pathology of trauma, the clinical injury severity, and chest tube placement (CTP) before and after CT. In a single-center retrospective analysis of 616 intubated and mechanically ventilated adult patients admitted directly from the scene to the emergency department (ED), 224 underwent CTP (36%). Of these, 142 patients (62%) underwent CTP before CT, of which, 125 (88%) had significant chest injury on CT. Seventeen patients had minor or absent chest injuries, most of which were associated with transient or unrecognized tracheal tube malposition. After CT, CTP was performed in another 82 patients, of which, 56 (68.3%) had relevant pneumothorax and 26 had minor findings on CT. Sixty patients who had already undergone CTP before CT received another CTP after CT, of which, 15 (25%) had relevant pneumothorax and 45 (75%) had functionality issues or malposition requiring replacement. Nine patients showed small pneumothorax on CT, and did not undergo CTP (including four patients with CTP before CT). The physiological variables were unspecific, and the trauma scores were dependent on the CT findings for identifying patients at risk for CTP. In conclusion, the clinical decisions for CTP before CT are associated with relevant false-negative and false-positive cases. Clinical assessment and CT imaging, together, are important indicators for CTP decisions that cannot be achieved by using clinical assessment or CT alone.

AB - The rate of occult pneumothorax in intubated and mechanically ventilated trauma patients until initial computed tomography (CT) remains undetermined. The primary aims of this study were to analyze initial chest CTs with respect to the thoracic pathology of trauma, the clinical injury severity, and chest tube placement (CTP) before and after CT. In a single-center retrospective analysis of 616 intubated and mechanically ventilated adult patients admitted directly from the scene to the emergency department (ED), 224 underwent CTP (36%). Of these, 142 patients (62%) underwent CTP before CT, of which, 125 (88%) had significant chest injury on CT. Seventeen patients had minor or absent chest injuries, most of which were associated with transient or unrecognized tracheal tube malposition. After CT, CTP was performed in another 82 patients, of which, 56 (68.3%) had relevant pneumothorax and 26 had minor findings on CT. Sixty patients who had already undergone CTP before CT received another CTP after CT, of which, 15 (25%) had relevant pneumothorax and 45 (75%) had functionality issues or malposition requiring replacement. Nine patients showed small pneumothorax on CT, and did not undergo CTP (including four patients with CTP before CT). The physiological variables were unspecific, and the trauma scores were dependent on the CT findings for identifying patients at risk for CTP. In conclusion, the clinical decisions for CTP before CT are associated with relevant false-negative and false-positive cases. Clinical assessment and CT imaging, together, are important indicators for CTP decisions that cannot be achieved by using clinical assessment or CT alone.

U2 - 10.3390/jcm11144043

DO - 10.3390/jcm11144043

M3 - SCORING: Journal article

C2 - 35887807

VL - 11

JO - J CLIN MED

JF - J CLIN MED

SN - 2077-0383

IS - 14

M1 - 4043

ER -