A Portable Handpump Is Effective in the Evacuation of Hemothorax in a Swine Model of Penetrating Chest Injury

Amin Jaskille, Peter M Rhee, Elena Koustova, Timothy Hancock, Ryan Inocencio, Troy A. Lewis, Adam Seufert, Hasan B. Alam

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Standard pleural evacuation devices are not practical for use on the battlefield. A small, portable, easy-to-use handpump (HP) that does not require continuous suction for treating hemopneumothorax would offer a major logistical advantage. In addition, using endotracheal tubes instead of regular pleural tubes would help minimize supplies carried on the battlefield. A swine model of penetrating chest injury was designed to test this concept. Our hypothesis was that an HP would be as effective as the standard of care for the evacuation of a large hemopneumothorax. Methods: A 2-cm lung laceration was created in 18 Yorkshire swine (35-51 kg) under inhaled anesthesia and 1.4 L of blood was infused into the pleural space (200 mL every 15 minutes). Fluid resuscitation (2,000 mL of 0.9% saline) was started 15 minutes after injury, and animals were randomized into one of three groups: group 1, 36-Fr Argyle pleural tube and Pleur-Evac chest drainage unit with 20-cm H2O suction (control); group 2, 36-Fr pleural tube attached to the HP; and group 3, a No. 8 endotracheal tube in the pleural space attached to the HP. After 120 minutes, a thoracotomy was performed to determine the amount of residual blood in the pleural space. Results: Effectiveness of the three methods as a percentage of total blood (evacuated and retained) removed was measured over 2 hours. The handpump (group 2) performed better than the standard of care (group 1) at numerous time points and evacuated significantly (p < 0.05) more blood at the end of the experiment. Conclusion: Using the handpump with a pleural tube was more effective than the standard of care in treating traumatic hemothorax. The use of an endotracheal instead of a conventional pleural tube had no adverse impact on efficacy of the pump in evacuating blood from the chest cavity.

Original languageEnglish (US)
Pages (from-to)864-868
Number of pages5
JournalJournal of Trauma
Volume55
Issue number5
DOIs
StatePublished - Nov 2003
Externally publishedYes

Fingerprint

Hemothorax
Thoracic Injuries
Swine
Standard of Care
Hemopneumothorax
Suction
Thorax
Lacerations
Thoracotomy
varespladib methyl
Resuscitation
Drainage
Anesthesia
Equipment and Supplies
Lung
Wounds and Injuries

Keywords

  • Battlefield
  • Combat casualty
  • Handpump
  • Hemothorax
  • Lung injury
  • Penetrating chest injury
  • Pneumothorax

ASJC Scopus subject areas

  • Surgery

Cite this

A Portable Handpump Is Effective in the Evacuation of Hemothorax in a Swine Model of Penetrating Chest Injury. / Jaskille, Amin; Rhee, Peter M; Koustova, Elena; Hancock, Timothy; Inocencio, Ryan; Lewis, Troy A.; Seufert, Adam; Alam, Hasan B.

In: Journal of Trauma, Vol. 55, No. 5, 11.2003, p. 864-868.

Research output: Contribution to journalArticle

Jaskille, A, Rhee, PM, Koustova, E, Hancock, T, Inocencio, R, Lewis, TA, Seufert, A & Alam, HB 2003, 'A Portable Handpump Is Effective in the Evacuation of Hemothorax in a Swine Model of Penetrating Chest Injury', Journal of Trauma, vol. 55, no. 5, pp. 864-868. https://doi.org/10.1097/01.TA.0000090036.55859.54
Jaskille, Amin ; Rhee, Peter M ; Koustova, Elena ; Hancock, Timothy ; Inocencio, Ryan ; Lewis, Troy A. ; Seufert, Adam ; Alam, Hasan B. / A Portable Handpump Is Effective in the Evacuation of Hemothorax in a Swine Model of Penetrating Chest Injury. In: Journal of Trauma. 2003 ; Vol. 55, No. 5. pp. 864-868.
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abstract = "Background: Standard pleural evacuation devices are not practical for use on the battlefield. A small, portable, easy-to-use handpump (HP) that does not require continuous suction for treating hemopneumothorax would offer a major logistical advantage. In addition, using endotracheal tubes instead of regular pleural tubes would help minimize supplies carried on the battlefield. A swine model of penetrating chest injury was designed to test this concept. Our hypothesis was that an HP would be as effective as the standard of care for the evacuation of a large hemopneumothorax. Methods: A 2-cm lung laceration was created in 18 Yorkshire swine (35-51 kg) under inhaled anesthesia and 1.4 L of blood was infused into the pleural space (200 mL every 15 minutes). Fluid resuscitation (2,000 mL of 0.9{\%} saline) was started 15 minutes after injury, and animals were randomized into one of three groups: group 1, 36-Fr Argyle pleural tube and Pleur-Evac chest drainage unit with 20-cm H2O suction (control); group 2, 36-Fr pleural tube attached to the HP; and group 3, a No. 8 endotracheal tube in the pleural space attached to the HP. After 120 minutes, a thoracotomy was performed to determine the amount of residual blood in the pleural space. Results: Effectiveness of the three methods as a percentage of total blood (evacuated and retained) removed was measured over 2 hours. The handpump (group 2) performed better than the standard of care (group 1) at numerous time points and evacuated significantly (p < 0.05) more blood at the end of the experiment. Conclusion: Using the handpump with a pleural tube was more effective than the standard of care in treating traumatic hemothorax. The use of an endotracheal instead of a conventional pleural tube had no adverse impact on efficacy of the pump in evacuating blood from the chest cavity.",
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AU - Inocencio, Ryan

AU - Lewis, Troy A.

AU - Seufert, Adam

AU - Alam, Hasan B.

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N2 - Background: Standard pleural evacuation devices are not practical for use on the battlefield. A small, portable, easy-to-use handpump (HP) that does not require continuous suction for treating hemopneumothorax would offer a major logistical advantage. In addition, using endotracheal tubes instead of regular pleural tubes would help minimize supplies carried on the battlefield. A swine model of penetrating chest injury was designed to test this concept. Our hypothesis was that an HP would be as effective as the standard of care for the evacuation of a large hemopneumothorax. Methods: A 2-cm lung laceration was created in 18 Yorkshire swine (35-51 kg) under inhaled anesthesia and 1.4 L of blood was infused into the pleural space (200 mL every 15 minutes). Fluid resuscitation (2,000 mL of 0.9% saline) was started 15 minutes after injury, and animals were randomized into one of three groups: group 1, 36-Fr Argyle pleural tube and Pleur-Evac chest drainage unit with 20-cm H2O suction (control); group 2, 36-Fr pleural tube attached to the HP; and group 3, a No. 8 endotracheal tube in the pleural space attached to the HP. After 120 minutes, a thoracotomy was performed to determine the amount of residual blood in the pleural space. Results: Effectiveness of the three methods as a percentage of total blood (evacuated and retained) removed was measured over 2 hours. The handpump (group 2) performed better than the standard of care (group 1) at numerous time points and evacuated significantly (p < 0.05) more blood at the end of the experiment. Conclusion: Using the handpump with a pleural tube was more effective than the standard of care in treating traumatic hemothorax. The use of an endotracheal instead of a conventional pleural tube had no adverse impact on efficacy of the pump in evacuating blood from the chest cavity.

AB - Background: Standard pleural evacuation devices are not practical for use on the battlefield. A small, portable, easy-to-use handpump (HP) that does not require continuous suction for treating hemopneumothorax would offer a major logistical advantage. In addition, using endotracheal tubes instead of regular pleural tubes would help minimize supplies carried on the battlefield. A swine model of penetrating chest injury was designed to test this concept. Our hypothesis was that an HP would be as effective as the standard of care for the evacuation of a large hemopneumothorax. Methods: A 2-cm lung laceration was created in 18 Yorkshire swine (35-51 kg) under inhaled anesthesia and 1.4 L of blood was infused into the pleural space (200 mL every 15 minutes). Fluid resuscitation (2,000 mL of 0.9% saline) was started 15 minutes after injury, and animals were randomized into one of three groups: group 1, 36-Fr Argyle pleural tube and Pleur-Evac chest drainage unit with 20-cm H2O suction (control); group 2, 36-Fr pleural tube attached to the HP; and group 3, a No. 8 endotracheal tube in the pleural space attached to the HP. After 120 minutes, a thoracotomy was performed to determine the amount of residual blood in the pleural space. Results: Effectiveness of the three methods as a percentage of total blood (evacuated and retained) removed was measured over 2 hours. The handpump (group 2) performed better than the standard of care (group 1) at numerous time points and evacuated significantly (p < 0.05) more blood at the end of the experiment. Conclusion: Using the handpump with a pleural tube was more effective than the standard of care in treating traumatic hemothorax. The use of an endotracheal instead of a conventional pleural tube had no adverse impact on efficacy of the pump in evacuating blood from the chest cavity.

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