Thoracic lavage

Overview

  • Active internal re-warming for hypothermic patients
  • Avoid left sided tubes in a perfusing patient since the heart is irritable.

Indications

Consider in:

  • Severe Hypothermia
  • Cardiovascular instability / life-threatening dysrhythmias
  • Moderate hypothermia which fails to respond to less aggressive measures

Contraindications

Equipment Needed

Procedure

One Tube System

  • Single Lateral Thoracostomy Tube
    • Introduce large bolus of warmed saline
    • Allow fluid to sit for 15-20 mins and then drain

Two Tube System

Two Tube System
  • Anterior Tube
    • Site at 2nd-3rd intercostal space at the midclavicular line
    • Attach to a high rate infuser at 40-45°C
    • Infuse 200 to 300mL
    • This tube can be a pigtail
  • Lateral Tube
    • 4-6th Intercostal space at post-axillary line
    • Attach to continuous drainage via pleur-evac or auto-transfuser (if using autotranfuser can re-attach to warming line for closed circuit)

Complications

See Also

External Links

References