Haemothorax refers to a blood collection within the pleural cavity. The primary cause is sharp or blunt trauma to the chest whereas iatrogenic haemothorax due to thoracentesis occur rarely with a risk between 0.6% and 1% even in critically ill patients.
Awake VATS has been advocated as an optimal strategy to perform a number of thoracic surgery procedures. Optimal indications are still widely debated but patients with impaired respiratory function and associated co-morbidity are deemed amongst the ideal candidates.
To our knowledge this is the first report entailing urgent awake VATS management of clotted haemothorax. So far, Katlic and Facktor only, reported on VATS performed in spontaneously ventilating patients with haemothorax although in this series unconscious sedation and standard 3-ports approach were employed. Moreover, in the Katlic’s series it is not mentioned whether these procedures were performed in an elective or urgent setting.