Thoracic lavage
Overview
- Active internal re-warming for hypothermic patients
- Avoid left sided tubes in a perfusing patient since the heart is irritable.
- Rewarms at a rate of 3°C/hr
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
- 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)