Devices to Prevent and Treat Retained Hemothorax after Chest Injury

Blood in thechestcavity (hemothorax) as a result of injury remains a common and seriouschallengein military and civilian trauma management. The primary treatment of hemothoraxrequires a tubeto beinserted into the pleural space around thelung. Unfortunately, in about20% of thecases,significant amounts of blood,clot, and fibrin remain after initial drainage.Left untreated, thiscan lead to a permanent reduction in lungfunction, infection, or scarring. Current management of this "retained hemothorax" demands additional surgical procedures resultingin morbidity and excesscost. To address this problem,we propose a "prevention strategy". Overcoming outdated simple,straight chest tubetechnology,we have developed a steerablechest tubethatcan be directed by the provider to the dependent pleural space where hemothorax usually accumulates, thus providing better drainage. Extendablecannulas traverseseparatechannels down thechest tube and will be advanced directly into the blood pool forearly instillation of dilute anticoagulant . A newly designed portablesuction/infusion pump will connect to thesystem. A novel bedsideendoscopic approach for pleural drainageis also being developed. Testingin manikins, animals, and cadavers will documenteffectiveness.Marketing and regulatory compliancestrategies should promote preferential clinical use