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bleeding AND thoracentesis

Alexandre de Oliveira, Thais Amarante P P Couto
BACKGROUND: The use of uniportal video-assisted thoracoscopic surgery (VATS) has been increasing worldwide. Our main goal was to describe the evolution of uniportal surgery in the biggest private hospital in Latin America that is located in São Paulo, Brazil. METHODS: This descriptive and retrospective study included patients who underwent uniportal VATS in the thoracic surgical department of Beneficencia Portuguesa Hospital, after being referred to our team to undergo the aforementioned procedure within the period from February 2012 to March 2016...
April 2017: Journal of Thoracic Disease
Ariel Grajales-Cruz, Francis Baco-Viera, Ernesto Rive-Mora, Carlos Ramirez-Tanchez, David Tasso, Norma Arroyo-Portela, Elizabeth Calderon, Ilean Joan Padua-Octaviani, William Caceres-Perkins
A man aged 69 years presented with acute right flank pain secondary to a hemorrhagic large adrenal tumor. En bloc resection was performed to repair the inferior vena cava. Immunoperoxidase levels in the tumor were positive for factor VIII and CD31 and negative for S100, protein Melan-A, CD34, synaptophysin, chromogranin, desmin, muscle specific actin, ETFA (EMA), KRT20 (CK20), CDX2, TTF1, LNPEP (PLAP), inhibin, ?-fetoprotein, CD30, hepatocyte paraffin, and aberrant expression of cytokeratin 7 and pankeratin...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
Tsung-Hsing Hung, Chih-Wei Tseng, Chen-Chi Tsai, Yu-Hsi Hsieh, Kuo-Chih Tseng, Chih-Chun Tsai
BACKGROUND: Pleural effusion is an abnormal collection of body fluids that may cause related morbidity or mortality in cirrhotic patients. There are insufficient data to determine the optimal method of drainage, for symptomatic relief in cirrhotic patients with pleural effusion. AIMS: In this study, we compare the mortality outcomes of catheter drainage versus thoracentesis in cirrhotic patients. METHODS: The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to identify cirrhotic patients with pleural effusion requiring drainage between January 1, 2007, and December 31, 2010...
April 2017: Digestive Diseases and Sciences
Nathan E Smith, Jeevan Joseph, John Morgan, Saqib Masroor
OBJECTIVE: Atrial fibrillation (AF) is the primary cardiac abnormality associated with ischemic stroke. Atrial fibrillation affects 2.7 million people with a stroke rate of 3.5% per year. Most of the emboli in patients with nonvalvular AF originate in the left atrial appendage (LAA). Surgical exclusion of the LAA decreases the yearly risk of stroke to 0.7% when combined with a Maze procedure. Traditional oversewing the LAA from inside the left atrium is associated with a significant number of recanalizations of LAA...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Eric P Cantey, James M Walter, Thomas Corbridge, Jeffrey H Barsuk
PURPOSE OF REVIEW: Although thoracentesis is generally considered safe, procedural complications are associated with increased morbidity, mortality, and healthcare costs. In this article, we review the risk factors and prevention of the most common complications of thoracentesis including pneumothorax, bleeding (chest wall hematoma and hemothorax), and re-expansion pulmonary edema. RECENT FINDINGS: Recent data support the importance of operator expertise and the use of ultrasound in reducing the risk of iatrogenic pneumothorax...
July 2016: Current Opinion in Pulmonary Medicine
Ko Sakatsume, Masatoshi Akiyama, Kenki Saito, Shunsuke Kawamoto, Hisanori Horiuchi, Yoshikatsu Saiki
A 61-year-old man was implanted with a Jarvik 2000, a continuous axial flow type left ventricular assist device (LVAD), for end-stage heart failure due to dilated cardiomyopathy. One month later, his postoperative course was complicated with intractable oozing-type gastrointestinal bleeding from multiple small shallow ulcers and erosions in the colon. In addition, repeated bleeding episodes were encountered at around thoracentesis site for pleural effusion. Hematological examination showed that platelet counts and coagulation factors were kept within normal ranges...
September 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Alexander T Hawkins, Maria J Schaumeier, Ann D Smith, Marit S de Vos, Karen J Ho, Marcus E Semel, Louis L Nguyen
OBJECTIVE: Surgical treatment of acute axillosubclavian vein thrombosis from venous thoracic outlet syndrome (VTOS) traditionally involves first rib resection and scalenectomy (FRRS) followed by interval venography and balloon angioplasty. This approach can lead to an extended need for anticoagulation and a separate anesthesia session. We present outcomes for FRRS with concurrent venography. METHODS: Retrospective chart review was performed for consecutive patients undergoing FRRS with concurrent venography for VTOS from February 2007 to April 2014...
July 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Krysta S Wolfe, John P Kress
Patients who are critically ill and hospitalized often require invasive procedures as a part of their medical care. Each procedure carries a unique set of risks and associated complications, but common to all of them is the risk of hemorrhage. Central venous catheterization, arterial catheterization, paracentesis, thoracentesis, tube thoracostomy, and lumbar puncture constitute a majority of the procedures performed in patients who are hospitalized. In this article, the authors will discuss the risk factors for bleeding complications from each of these procedures and methods to minimize risk...
July 2016: Chest
Tao Chen, Chen Zhang, Li-Qing Yao, Ping-Hong Zhou, Yun-Shi Zhong, Yi-Qun Zhang, Wei-Feng Chen, Quan-Lin Li, Ming-Yan Cai, Yuan Chu, Mei-Dong Xu
BACKGROUND AND STUDY AIMS: Submucosal tunneling endoscopic resection (STER) has become a potential option for the endoscopic treatment of a selected group of patients with submucosal tumors (SMTs) originating from the muscularis propria layer in the upper gastrointestinal tract. The aim of this retrospective study was to analyze the incidence and management of STER-related complications. PATIENTS AND METHODS: From January 2011 to August 2013, 290 patients with upper gastrointestinal SMTs treated by STER were included in the study...
February 2016: Endoscopy
Nilam J Soni, Ricardo Franco, Maria I Velez, Daniel Schnobrich, Ria Dancel, Marcos I Restrepo, Paul H Mayo
We review the literature on the use of point-of-care ultrasound to evaluate and manage pleural effusions. Point-of-care ultrasound is more sensitive than physical exam and chest radiography to detect pleural effusions, and avoids many negative aspects of computerized tomography. Additionally, point-of-care ultrasound can assess pleural fluid volume and character, revealing possible underlying pathologies and guiding management. Thoracentesis performed with ultrasound guidance has lower risk of pneumothorax and bleeding complications...
December 2015: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
L Dangers, T Similowski, C Chenivesse
BACKGROUND: When pleural procedures (thoracocentesis, blind pleural biopsies and chest tube insertion) are required in patients taking long-term platelet aggregation inhibitors, the risk of bleeding must be balanced against the risk of arterial thrombosis. Currently, the bleeding risk of pleural procedures is poorly understood. OBJECTIVE: The objective of the survey was to gather the opinion of respiratory physicians regarding the bleeding risk of pleural procedures in patients taking platelet aggregation inhibitors...
January 2016: Revue des Maladies Respiratoires
Yan Zhao, Jiahe Zhou, Zhenduo Shi, Conghui Han
The objective is to evaluate clinical indications and safety of tubeless percutaneous nephrolithotomy (PCNL) for the treatment of stones in upper urinary tract. A total of 231 subjects accepted to undergo tubeless PCNL, both micro-channel and standard operation were performed. After PCNL, renal gastrostomy tube was not placed also catheters and double-J stents were subsequently removed 3-5 and 14-28 days, respectively. Primary PCNL resulted in stone clearance of 98.27 %. There were five cases of postoperative hemorrhage with bleeding of about 500 ml, which was stopped by keeping patients in bed and medication...
June 2015: Cell Biochemistry and Biophysics
Mark J Ault, Bradley T Rosen, Jordan Scher, Joe Feinglass, Jeffrey H Barsuk
BACKGROUND: Despite a lack of evidence in the literature, several assumptions exist about the safety of thoracentesis in clinical guidelines and practice patterns. We aimed to evaluate specific demographic and clinical factors that have been commonly associated with complications such as iatrogenic pneumothorax, re-expansion pulmonary oedema (REPE) and bleeding. METHODS: We performed a cohort study of inpatients who underwent thoracenteses at Cedars-Sinai Medical Center (CSMC) from August 2001 to October 2013...
February 2015: Thorax
M Elizabeth Wilcox, Christopher A K Y Chong, Matthew B Stanbrook, Andrea C Tricco, Camilla Wong, Sharon E Straus
IMPORTANCE: Thoracentesis is performed to identify the cause of a pleural effusion. Although generally safe, thoracentesis may be complicated by transient hypoxemia, bleeding, patient discomfort, reexpansion pulmonary edema, and pneumothorax. OBJECTIVE: To identify the best means for differentiating between transudative and exudative effusions and also to identify thoracentesis techniques for minimizing the risk of complications by performing a systematic review the evidence...
June 18, 2014: JAMA: the Journal of the American Medical Association
Jonathan Puchalski
PURPOSE OF REVIEW: Thoracentesis is a commonly performed procedure throughout the world. Convention dictates that patients should have laboratory values such as international normalized ratio (INR) and platelets corrected or medications that affect bleeding withheld prior to performing this procedure. By transfusing blood products or withholding medications, patients are exposed to risks that are different than but equally if not more significant than the risk of hemothorax from thoracentesis...
July 2014: Current Opinion in Pulmonary Medicine
Jonathan T Puchalski, A Christine Argento, Terrence E Murphy, Katy L B Araujo, Margaret A Pisani
BACKGROUND: Thoracentesis is commonly performed to evaluate pleural effusions. Many medications (warfarin, heparin, clopidogrel) or physiological factors (elevated International Normalized Ratio [INR], thrombocytopenia, uremia) increase the risk for bleeding. Frequently these medications are withheld or transfusions are performed to normalize physiological parameters before a procedure. The safety of performing thoracentesis without correction of these bleeding risks has not been prospectively evaluated...
August 2013: Annals of the American Thoracic Society
Narendrakumar Alappan, Creticus Marak, Deborah Orsi, Thomas Aldrich
SESSION TYPE: Pleural Cases IPRESENTED ON: Tuesday, October 23, 2012 at 11:15 AM - 12:30 PMINTRODUCTION: Hemothorax is mostly related to closed or open chest trauma or procedures in relation to chest wall. Spontaneous hemothorax is much less common. Here we describe a patient who presented with spontaneous massive hemothorax, a methodical search for etiology led to the diagnosis.CASE PRESENTATION: A 56 year old Hispanic female, with history significant for recurrent epistaxis since the age of 10 was electively admitted by her gastroenterologist for evaluation of iron deficiency anemia...
October 1, 2012: Chest
Matthew Salamonsen, Karen Dobeli, David McGrath, Craig Readdy, Robert Ware, Karin Steinke, David Fielding
BACKGROUND AND OBJECTIVE: Laceration of the intercostal artery during pleural procedures is a rare but serious complication. This study evaluates the utility of thoracic ultrasound (US) to screen for a vulnerable vessel compared with the gold standard computed tomography (CT). METHODS: Before undergoing contrast-enhanced CT chest, thoracic US was performed on 50 patients with a high-end and portable machine, and an attempt made to visualize the vessel at three positions across the back to the axilla...
August 2013: Respirology: Official Journal of the Asian Pacific Society of Respirology
Catherine J Mercaldi, Stephan F Lanes
Ultrasound guidance enables visualization of the needle insertion site for thoracentesis and paracentesis. The improved accuracy of needle placement using ultrasound may reduce risk of complications and their costs associated with these procedures. Using claims data from the Premier Perspective hospital database from January 1, 2007, through December 31, 2008, we conducted an observational cohort study examining the effect of ultrasound guidance on risk of pneumothorax among patients undergoing thoracentesis and on risk of bleeding complications after paracentesis...
February 1, 2013: Chest
Kay Choong See, Khalizah Jamil, Ai Ping Chua, Jason Phua, Kay Leong Khoo, Tow Keang Lim
BACKGROUND AND OBJECTIVE: Bedside ultrasound allows direct visualization of pleural collections for thoracentesis and tube thoracostomy. However, there is little information on patient safety improvement methods with this approach. The effect of a checklist on patient safety for bedside ultrasound-guided pleural procedures was evaluated. METHODS: A prospective study of ultrasound-guided pleural procedures from September 2007 to June 2010 was performed. Ultrasound guidance was routine practice for all patients under the institution's care and the freehand method was used...
April 2013: Respirology: Official Journal of the Asian Pacific Society of Respirology
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