Browse > Article

Complications of a Tube Thoracostomy Performed by Emergency Medicine Residents  

Cho, Dai Yun (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chung-Ang University)
Sohn, Dong Suep (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chung-Ang University)
Cheon, Young Jin (Department of Emergency Medicine, College of Medicine, Ewha Womans University)
Hong, Kihun (Major in Preventive Medicine, Department of Medical College, The Graduate School Chung-Ang University)
Publication Information
Journal of Trauma and Injury / v.25, no.2, 2012 , pp. 37-43 More about this Journal
Abstract
Purpose: A tube thoracostomy is an invasive procedure that places patients at risk for complications. Tube thoracostomies are frequently performed by emergency medicine residents. Thus, the purpose of the study was to assess both the complication rate for tube thoracostomies performed by emergency medicine residents and the factors associated with these complications. Methods: A retrospective chart review of all patients who had undergone a tube thoracostomy performed by emergency medicine residents between January 2008 and February 2009 was conducted at a university hospital. Complications were divided into major and minor complications and into immediate and delayed complications. Complications requiring corrective surgical intervention, requiring the administration of blood products, or involving situations requiring intravenous antibiotics were defined as major. Complications that were detected within 2 hours were defined as immediate. Results: Tube thoracostomies were performed in 189 patients, and 70 patients(37%) experienced some complications. Most complications were immediate and minor. In multiple logistic regressions, BMI, hypotension and resident seniority were significantly associated with complications. Conclusion: The prevalence of complications was similar to these in previous reports on the complications of a tube thoracostomy. Most complications from tube thoracostomies performed by emergency medicine residents were immediate and minor complications. Thus, emergency medicine residents should be allowed to perform closed tube thoracostomies instead of thoracic surgeons.
Keywords
Tube thoracostomy; Complications; Emergency medicine residents;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Millikan JS, Moore EE, Steiner E, Aragon GE, Van Way CW. Complications of tube thoracostomy in acute trauma. Am J Surg 1980;140:738-41.   DOI
2 Sato S, Demura S. Regional subcutaneous fat characteristics stratified by sex, age, and obesity, and their relationships with total and visceral fat in a Japanese population. J Physiol Anthropol 2009;28:231-8.   DOI
3 Fujiki M, Guta CG, Lemmens HJ, Brock-Utne JG. Is it more difficult to cannulate the right internal jugular vein in morbidly obese patients than in nonobese patients? Obes Surg 2008;15:1157-9.
4 Lefrant JY, Muller L, De La Coussaye JE, Prudhomme M, Ripart J, Gouzes C, et al. Risk factors of failure and immediate complication of subclavian vein catheterization in critically ill patients. Intensive Care Med 2002; 28:1036-41.   DOI
5 Patel AD, Albrizio M. Relationship of body mass index to early complications in knee replacement surgery. Arch Orthop Trauma Surg 2008;128:5-9.
6 Yadla S, Malone J, Campbell PG, Maltenfort MG, Harrop JS, Sharan AD, et al. Obesity and spine surgery: reassessment based on a prospective evaluation of perioperative complications in elective degenerative thoracolumbar procedures. Spine J 2010 Article in Press, Corrected Proof.
7 Gillespie GN, Porteous AJ. Obesity and knee arthroplasty. Knee 2007;14:81-6.   DOI
8 Phua GC, Wahidi MM. ICU procedures of the critically ill. Respirology 2009;14:1092-7.   DOI
9 Remerand F, Luce V, Badachi Y, Lu Q, Bouhemad B, Rouby JJ. Incidence of chest tube malposition in the critically ill: a prospective computed tomography study. Anesthesiology 2007;106:1112-9.   DOI   ScienceOn
10 Huber-Wagner S, Korner M, Ehrt A, Kay MV, Pfeifer KJ, Mutschler W, et al. Emergency chest tube placement in trauma care - which approach is preferable? Resuscitation 2007;72:226-33.   DOI   ScienceOn
11 Ball CG, Lord J, Laupland KB, Gmora S, Mulloy RH, Ng AK, et al. Chest tube complications:how well are we training our residents? Can J Surg 2007;50:450-8.
12 Maritz D, Wallis L, Hardcastle T. Complications of tube thoracostomy for chest trauma. S Afr Med J 2009;99: 114-7.
13 Sethuraman KN, Duong D, Mehta S, Director T, Crawford D, St George J, et al. Complications of tube thoracostomy placement in the emergency department. J Emerg Med 2011;40:14-20.   DOI
14 Bailey RC. Complications of tube thoracostomy in trauma. J Accid Emerg Med 2000;17:111-4.   DOI
15 Hishikawa S, Kawano M, Tanaka H, Konno K, Yasuda Y, Kawano R, et al. Mannequin simulation improves the confidence of medical students performing tube thoracostomy: a prospective, controlled trial. Am Surg. 2010;76:73-8.
16 Custalow CB, Kline JA, Marx JA, Baylor MR. Emergency department resuscitative procedures: animal laboratory training improves procedural competency and speed. Acad Emerg Med. 2002;9:575-86.   DOI
17 Lee KW. Clinical analysis of trauma surgery patients in a local emergency center; Does emergency physicians' treatment delay the surgeons'special care like emergency operations for trauma victims? J Korean Soc Traumatol 2007;20:19-25.
18 Chan L, Reilly KM, Henderson C, Kahn F, Salluzzo RF. Complication rates of tube thoracostomy. Am J Emerg Med 1997;15:368-70.   DOI
19 Hyun SY, Oh SW, Kim JK, Lim YS, Yang HJ, Lee G, et al. Clinical analysis of patients with thorax or neck trauma treated with emergent operations. J Korean Soc Traumatol 2003;16:116-23.
20 WHO/IASO/IOTF. The Asia-Pacific perspective: redefining obesity and its treatment. Health Communications Australia: Melbourne, 2000. Available at:http://apps.who.int/bmi/index.jsp?introPage=intro_3 .html Accessed May 1. 2010.
21 Etoch SW, Bar-Natan MF, Miller FB, Richardson JD. Tube thoracostomy. Factors related to complications. Arch Surg 1995;130:521-5.   DOI
22 Helling TS, Gyles NR 3rd, Eisenstein CL, Soracco CA. Complications following blunt and penetrating injuries in 216 victims of chest trauma requiring tube thoracostomy. J Trauma 1989;29:1367-70.   DOI