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Module 4: Thoracic Injuries

Segment 5: Open Pneumothorax & Hemothorax

References labeled PEDS contain a pediatric element or primary focus.

Topic: Open pneumothorax

  • Butler FK, Dubose JJ, Otten EJ, et al. Management of open pneumothorax in Tactical Combat Casualty Care: TCCC Guidelines Change 13-02. J Spec Oper Med. 2013;13(3):81-6. doi: 10.55460/739G-PP0W. https://pubmed.ncbi.nlm.nih.gov/24048995/.
  • Kuhlwilm V. The use of chest seals in treating sucking chest wounds: A comparison of existing evidence and guideline recommendations. J Spec Oper Med. 2021;21(1):94-101. doi: 10.55460/3G6H-14FD https://pubmed.ncbi.nlm.nih.gov/33721314/.
  • Walthall K. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 3: In a penetrating chest wound is a three-sided dressing or a one-way chest seal better at preventing respiratory complications? Emerg Med J. 2012;29(4):342-3. doi: 10.1136/emermed-2012-201159.4 https://pubmed.ncbi.nlm.nih.gov/22420002/.

Topic: Hemothorax

  • Al Tannir AH, Biesboer EA, Golestani S, et al. Thoracic cavity irrigation prevents retained hemothorax and decreases surgical intervention in trauma patients. J Trauma Acute Care Surg. 2024;97(1):90-95. doi: 10.1097/ta.0000000000004324 https://pubmed.ncbi.nlm.nih.gov/38523131/.
  • Alomar Z, El-Khatib A, Khreibeh M, et al. Outcomes of conservative management of CT-diagnosed hemothorax in chest trauma: A systematic review and meta-analysis. Injury. 2026;57(10):113476. doi: 10.1016/j.injury.2026.113476 https://pubmed.ncbi.nlm.nih.gov/42475926/.
  • Bauman ZM, Kulvatunyou N, Joseph B, et al. Randomized clinical trial of 14-French (14F) pigtail catheters versus 28-32F chest tubes in the management of patients with traumatic hemothorax and hemopneumothorax. World J Surg. 2021;45(3):880-886. doi: 10.1007/s00268-020-05852-0 https://pubmed.ncbi.nlm.nih.gov/33415448/.
  • Beeton G, Ngatuvai M, Breeding T, et al. Outcomes of pigtail catheter placement versus chest tube placement in adult thoracic trauma patients: A systematic review and meta-analysis. Am Surg. 2023;89(6):2743-2754. doi: 10.1177/00031348231157809 https://pubmed.ncbi.nlm.nih.gov/36802811/.
  • Carver TW, Berndtson AE, McNickle AG, et al. Thoracic irrigation for prevention of secondary intervention after thoracostomy tube drainage for hemothorax: A Western Trauma Association multicenter study. J Trauma Acute Care Surg. 2024;97(5):724-730. doi: 10.1097/ta.0000000000004364 https://pubmed.ncbi.nlm.nih.gov/38764139/.
  • Choi J, Villarreal J, Andersen W, et al. Scoping review of traumatic hemothorax: Evidence and knowledge gaps, from diagnosis to chest tube removal. Surgery. 2021;170(4):1260-1267. doi: 10.1016/j.surg.2021.03.030 https://pubmed.ncbi.nlm.nih.gov/33888318/.
  • Curfman KR, Robitsek RJ, Salzler GG, et al. Massive hemothorax caused by a single intercostal artery bleed ten days after solitary minimally displaced rib fracture. Case Rep Surg. 2015;2015:120140. doi: 10.1155/2015/120140 https://pubmed.ncbi.nlm.nih.gov/26618020/.
  • Edu S, Nicol A, Neuhaus V, et al. Late video-assisted thoracoscopic surgery versus thoracostomy tube reinsertion for retained hemothorax after penetrating trauma, a prospective randomized control study. World J Surg. 2024;doi: 10.1002/wjs.12181 https://pubmed.ncbi.nlm.nih.gov/38588034/.
  • Granieri S, Cioffi SPB, Asaro A, et al. Small versus large bore chest tube in traumatic hemothorax, hemopneumothorax, and pneumothorax: a meta-analysis of randomized controlled trials with trial sequential analysis. World J Emerg Surg. 2025;20(1):87. doi: 10.1186/s13017-025-00655-x https://pubmed.ncbi.nlm.nih.gov/41287089/.
  • Holsen MR, Tameron AM, Evans DC, et al. Intrapleural tissue plasminogen activator for traumatic retained hemothorax. Ann Pharmacother. 2019;53(10):1060-1066. doi: 10.1177/1060028019846122 https://pubmed.ncbi.nlm.nih.gov/31007039/.
  • Huang FD, Yeh WB, Chen SS, et al. Early management of retained hemothorax in blunt head and chest trauma. World J Surg. 2018;42(7):2061-2066. doi: 10.1007/s00268-017-4420-x https://pubmed.ncbi.nlm.nih.gov/29305711/.
  • Kulvatunyou N, Bauman ZM, Zein Edine SB, et al. The small (14 Fr) percutaneous catheter (P-CAT) versus large (28–32 Fr) open chest tube for traumatic hemothorax: A multicenter randomized clinical trial. J Trauma Acute Care Surg. 2021;91(5):809-813. doi: 10.1097/ta.0000000000003180 https://pubmed.ncbi.nlm.nih.gov/33843831/.
  • Lyons NB, Abdelhamid MO, Collie BL, et al. Small versus large-bore thoracostomy for traumatic hemothorax: A systematic review and meta-analysis. J Trauma Acute Care Surg. 2024;97(4):631-638. doi: 10.1097/ta.0000000000004412 https://pubmed.ncbi.nlm.nih.gov/39213292/.
  • Mahmood I, Alomar A, Nabir S, et al. Computed tomography–detected hemothorax after blunt chest trauma: Does everyone need an intervention? A retrospective analysis. Injury. 2025;doi: 10.1016/j.injury.2025.112532 https://pubmed.ncbi.nlm.nih.gov/40555636/.
  • McLauchlan N, Ali A, Beyer CA, et al. Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiative. Trauma Surg Acute Care Open. 2024;9(1):e001298. doi: 10.1136/tsaco-2023-001298 https://pubmed.ncbi.nlm.nih.gov/38440095/.
  • Tatakis A, Wilson D, Al Tannir AH, et al. Validation of a safe volumetric cut-off for observation of traumatic hemothorax: A Western Trauma Association multicenter study. J Trauma Acute Care Surg. 2026;doi: 10.1097/ta.0000000000004991 https://pubmed.ncbi.nlm.nih.gov/42029153/.
  • Prakash PS, Moore SA, Rezende-Neto JB, et al. Predictors of retained hemothorax in trauma: Results of an Eastern Association for the Surgery of Trauma multi-institutional trial. J Trauma Acute Care Surg. 2020;89(4):679-685. doi: 10.1097/ta.0000000000002881 https://pubmed.ncbi.nlm.nih.gov/32649619/.