Hemothorax medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
The mainstay of medical therapy for hemothorax is fluid resuscitation and blood transfusion. All patients, regardless of causes, require attention for fluid resuscitation and blood transfusion. Prophylactic use of [[Antibiotic|antibiotics]] following haemothorax reduces the rate of infectious complications such as [[pneumonia]] and [[Pleural empyema|empyema]] during at least 24 hours after the start of chest tube drainage. Antibiotic treatment should be directed to [[Staphylococcus aureus]] and [[Streptococcus|Streptococcus species]] and the use of [[Cephalosporins|first generation cephalosporins]] during the first 24 hours in patients treated with chest tube drainage is recommended. Intrapleural [[Fibrinolytic agent|fibrinolytic]] therapy (IPFT) has been advocated as an alternative to evacuating residual blood clots and break down adhesions in low-resource settings where the relatively costly and sophisticated technique of VATS may not be available, feasible or applicable. Several studies report on IPFT with [[streptokinase]], [[urokinase]] or [[tissue plasminogen activator]] (TPA). Duration of treatment with IPFT can vary between 2 and 9 days for streptokinase and 2–15 days for urokinase. | The mainstay of medical therapy for hemothorax is fluid resuscitation and blood transfusion. All patients, regardless of causes, require attention for fluid resuscitation and blood transfusion. Prophylactic use of [[Antibiotic|antibiotics]] following haemothorax reduces the rate of infectious complications such as [[pneumonia]] and [[Pleural empyema|empyema]] during at least 24 hours after the start of chest tube drainage. Antibiotic treatment should be directed to [[Staphylococcus aureus]] and [[Streptococcus|Streptococcus species]] and the use of [[Cephalosporins|first generation cephalosporins]] during the first 24 hours in patients treated with chest tube drainage is recommended. Intrapleural [[Fibrinolytic agent|fibrinolytic]] therapy (IPFT) has been advocated as an alternative to evacuating residual blood clots and break down adhesions in low-resource settings where the relatively costly and sophisticated technique of VATS may not be available, feasible or applicable. Several studies report on IPFT with [[streptokinase]], [[urokinase]] or [[tissue plasminogen activator]] (TPA). Duration of treatment with IPFT can vary between 2 and 9 days for streptokinase and 2–15 days for urokinase. | ||
PMID: 25922734 | |||
PMID: 25638240 | |||
PMID: 21740393 | |||
PMID: 25813733 | |||
PMID:20817498 | |||
PMID:26197910 | |||
PMID:9262119 | |||
PMID: 18716687 | |||
PMID: 24698396 | |||
PMID: 17483994 | |||
==Medical Therapy== | ==Medical Therapy== | ||
Revision as of 15:53, 30 April 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Irfan Dotani
Overview
The mainstay of medical therapy for hemothorax is fluid resuscitation and blood transfusion. All patients, regardless of causes, require attention for fluid resuscitation and blood transfusion. Prophylactic use of antibiotics following haemothorax reduces the rate of infectious complications such as pneumonia and empyema during at least 24 hours after the start of chest tube drainage. Antibiotic treatment should be directed to Staphylococcus aureus and Streptococcus species and the use of first generation cephalosporins during the first 24 hours in patients treated with chest tube drainage is recommended. Intrapleural fibrinolytic therapy (IPFT) has been advocated as an alternative to evacuating residual blood clots and break down adhesions in low-resource settings where the relatively costly and sophisticated technique of VATS may not be available, feasible or applicable. Several studies report on IPFT with streptokinase, urokinase or tissue plasminogen activator (TPA). Duration of treatment with IPFT can vary between 2 and 9 days for streptokinase and 2–15 days for urokinase.
PMID: 25922734
PMID: 25638240
PMID: 21740393
PMID: 25813733
PMID:20817498
PMID:26197910
PMID:9262119
PMID: 18716687
PMID: 24698396
PMID: 17483994
Medical Therapy
- Fluid resuscitation and blood transfusion
- Prophylactic use of antibiotics
- Intrapleural fibrinolytic therapy (IPFT)