Hemothoraces (HTXs) are common after thoracic injury and associated with significant morbidity and mortality [1]. The incidence of HTXs has been increasing in many centres with the ubiquitous use of computed tomography (CT) and adoption of
* Corresponding author at: University of Calgary, Foothills Medical Centre, 1403 29th Street NW, Calgary, Alberta T2N 2T9, Canada. Tel.: +1 403 944 3417;
fax: +1 403 944 8799.
E-mail address: ball.chad@gmail.com (C.G. Ball).
http://dx.doi.org/10.1016/j.injury.2015.04.032
0020–1383/ß 2015 Elsevier Ltd. All rights reserved.
ß 2015 Elsevier Ltd. All rights reserved.
‘‘pan-scanning’’ algorithms [2]. Although HTXs are effectively managed with tube thoracostomy (TT) drainage of the pleural space, this intervention is associated with numerous potential complications, including iatrogenic injury, retained HTXs, and empyema [3–7]. Recent consensus guidelines suggest all HTXs should be considered for drainage (regardless of size), as well as the inevitable complication profile of tube insertion itself, it is unclear if chest tubes are being over-utilized [7].
In a series of publications from the 1960s, Dr. Stein and colleagues described their experience with the management of 277 HTXs secondary to thoracic stab wounds [8,9]. Equipped with a crude system of approximating pleural fluid volume on