Hemothorax

Hemothorax means the accumulation of pus in the pleural space.

The usual cause of hemothorax is a laceration of the lung, blood vessels lying between the ribs, or an internal mammary artery. It can be caused by penetrating or blunt trauma. Hemothorax is often accompanied by pneumothorax (hemopneumothorax).

Hemothorax means the accumulation of pus in the pleural space. The usual cause of hemothorax is a laceration of the lung, blood vessels lying between the ribs, or an internal mammary artery. It can be caused by penetrating or blunt trauma. Hemothorax is often accompanied by pneumothorax (hemopneumothorax). The blood flow volume ranges from minimal to massive. A massive hemothorax is usually defined as a rapid accumulation of ? 1,000 ml of blood. Shock is widespread. Patients with large circulation volume often suffer from shortness of breath and have decreased breath sounds and dull percussion (often difficult during the first examination of patients with multiple injuries to recognize). Findings may be inconspicuous with smaller Hämothoraces in patients. Diagnostic chest X-ray, the suspicion of a hemothorax is based on symptoms and physical findings. The diagnosis is typically confirmed by chest x-ray. Fluid replacement therapy is normally required pleural drainage Sometimes thoracotomy patients with signs of hypovolemia (z. B. tachycardia, hypotension) received crystalloid iv and sometimes blood transfusion (The intravenous fluid replacement). When the blood volume is sufficient on chest X-ray (about 500 ml are usually required) to be visible, or if pneumothorax is present, is a large-caliber thoracic drainage (z. B. 32 to 38 Fr) on the 5th or 6th intercostal space inserted in the mid-axillary line. The drainage improves breathing, reduces the risk of clotted hemothorax (which can lead to empyema or fibrothorax), and facilitates the evaluation of sustained blood loss and diaphragm integrity. About thoracostomy collected blood can be transfused, which reduces the need for exogenous crystalloid and blood. An urgent thoracotomy is indicated in each of the following cases: Initial bleeding is> 1500 mL blood flow is 200 ml / h for 2 to 4 h and leads to respiratory or hemodynamic disturbances or requires repeated blood transfusions.

Health Life Media Team

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