Observation, no control |
Garramone et al, 1991 (19) | 26, multisystem trauma | 27 | Subjective | 10 failed observation | Prophylactic chest tube for general anesthetic |
|
Collins et al, 1992 (35) | 26, multisystem trauma | 23.5 | 11 chest tube | 1 intercostal injury 2 failed | Observation safe even with mechanical ventilation. |
22.8 | 13 observed |
|
Wolfman et al, 1998 (21) | 36, “some” ventilated | Unstated | 20 chest tube | No adverse reaction 3 progression of OP, 1 tension pneumothorax | Small pneumothoraces may not require a chest tube. |
24 observed |
|
Hill et al, 1999 (22) | 67 OPs | 16.5 | 27 observed | 5 failed | General anesthetic, airway pressure or positive end-expiratory pressure all warrant insertion of a chest tube. |
2 general anesthetic |
2 ventilated |
|
Prospective randomized |
Enderson et al, 1993 (14) | 40, 27 ventilated | 26.0 | 19 chest tube | No adverse reaction 8 progression of OP, 3 tension pneumothorax | Chest tube required for ventilated patients. |
26.3 | 21 observed |
|
Brasel et al, 1999 (15) | 39, 9 in each group ventilated | 22.4 | 18 chest tube | No adverse reaction 2 progression | Observation is safe. |
19.1 | 21 observed |