What is included in postoperative care following thoracotomy for the treatment of hemothorax?

Updated: Jul 13, 2020
  • Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: Jeffrey C Milliken, MD  more...
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Answer

Ventilator management should progress according to the individual status of the patient. In cases where no other significant injury or disease process is present, weaning and extubation may proceed in a routine fashion. In more critically ill patients such as those with severe chest wall injuries or those requiring massive transfusion, ventilator management must be tailored to the condition of the patient.

After extubation, pulmonary toilet and adequate pain control are critical in preventing pulmonary complications such as atelectasis and pneumonia.

Chest tubes are maintained on underwater seal suction, and the volume of drainage and air leak are noted and recorded daily. If pulmonary injury is found or resection of lung tissue is required at the time of surgery, chest tubes are not removed until any air leak has disappeared and the lung is fully expanded as viewed on the chest radiograph. Drainage should be less than 100 mL in 24 hours before chest tube removal.

Antibiotic coverage begun preoperatively should be discontinued after 48 hours unless a definite reason exists for continuance.

Ventilator management should progress according to the individual status of the patient. In cases in which no other significant injury or disease process is present, weaning and extubation may proceed in a routine fashion. In more critically ill patients, such as those with severe chest wall injuries or those requiring massive transfusion, ventilator management must be tailored to the condition of the patient. After extubation, pulmonary toilet and adequate pain control are critical in preventing pulmonary complications such as atelectasis and pneumonia.


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