Hemothorax natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Irfan Dotani

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Overview

Bleeding into the pleural space is exposed to the motion of the diaphragm, lungs, and other intrathoracic structures. The agitation of cardiac and respiratory movement defibrinates the blood, and a fibrin clot thus formed is deposited on the layers of pleura. After several hours, clot formation is inevitable and it should be evacuated. if left untreated, it may progress to develop some complications.

PMID: 24529771

PMID: 25813733

PMID: 20817498

PMID:26197910

PMID: 18716687

Natural History

Bleeding into the pleural space is exposed to the motion of the diaphragm, lungs, and other intrathoracic structures. The agitation of cardiac and respiratory movement defibrinates the blood, and a fibrin clot thus formed is deposited on the layers of pleura. Within several hours of cessation of bleeding, clot formation is inevitable and it will be difficult to remove. The membrane continues to thicken by progressive deposition, so the clotted haemothorax should be evacuated within a reasonable time after the onset of bleeding. Chronic and retained hemothorax may progress to develop [[Respiratory failure|respiratory distress}}, lung entrapment with impaired pulmonary function, retained clot, chronic fibrothorax, empyema and extended hospitalization if left untreated.

Complications

• Respiratory distress
• Lung entrapment
• Impaired pulmonary function
• Retained clot
• Chronic fibrothorax
• Empyema
• Extended hospitalization
• Atelectasis
• Pneumonia