Small size new silastic drains: life-threatening hypovolemic shock after thoracic surgery associated with a non-functioning chest tube

Article Article scientifique Rapport de cas Small size new silastic drains: life-threatening hypovolemic shock after thoracic surgery associated with a non-functioning chest tube eng 2007 author Clark Gregory 90361 author Licker Marc 133428 author Bertin Daniel-Jean 69345 author Spiliopoulos Anastase 49910 566-568 10.1016/j.ejcts.2006.12.010 17215136 1010-7940 We report a case of a massive haemothorax following bilateral surgical resection of apical bullae. Occult bleeding was not recognized until the onset of a life-threatening circulatory collapse associated with metabolic acidosis and a fall in haemoglobin level. Using a thoracotomy, large amounts of blood were evacuated from the thoracic cavity and bleeding originating from ruptured pleural adhesion was easily controlled. Thrombotic material with talc particles was found to obstruct the 19-French 4-channel Blake drain. Although this new silastic Blake tube has been recommended in cardiac surgical patients, extending its indication in thoracic surgery, particularly when talc pleurodesis is used, should be questioned given the enhanced postoperative prothrombotic state and risk of drain obstruction. In conclusion, caution should be exercised when new small-sized material is introduced in clinical practice, especially after talc pleurodesis following thoracic surgery. Adult Chest Tubes/adverse effects Equipment Failure Hemothorax/etiology/radiography Humans Male Pleurodesis/adverse effects Postoperative Care/adverse effects/instrumentation Postoperative Hemorrhage/etiology/radiography Shock/etiology Talc/administration & dosage Thoracotomy Dewey 617 57 Département de chirurgie 222 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 false 218 Dysfonctions cardio-pulmonaires et cérébrales 278 European journal of cardio-thoracic surgery 31 3 14b8b053-c051-4c96-85fc-5dfbbfb7ebc9 Article (Accepted version) Restricted 566.full.pdf 430051 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de chirurgie Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences

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Small size new silastic drains: life-threatening hypovolemic shock after thoracic surgery associated with a non-functioning chest tube	European journal of cardio-thoracic surgery	2007	634	0

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Clark, Gregory