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https://www.readbyqxmd.com/read/29241680/race-effects-of-inhaled-nitric-oxide-in-preterm-infants-an-individual-participant-data-meta-analysis
#1
Lisa M Askie, Lucy C Davies, Michael D Schreiber, Anna Maria Hibbs, Philip L Ballard, Roberta A Ballard
OBJECTIVE: To assess whether inhaled nitric oxide (iNO) improves survival without bronchopulmonary dysplasia (BPD) for preterm African American infants. STUDY DESIGN: An individual participant data meta-analysis was conducted, including 3 randomized, placebo-controlled trials that enrolled infants born at  <34 weeks of gestation receiving respiratory support, had at least 15% (or a minimum of 10 infants in each trial arm) of African American race, and used a starting iNO of >5  parts per million with the intention to treat for 7 days minimum...
December 11, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29239613/dewetting-of-thin-liquid-films-surrounding-air-bubbles-in-microchannels
#2
Sepideh Khodaparast, Omer Atasi, Antoine Deblais, Benoit Scheid, Howard A Stone
As an air bubble translates in a microchannel, a thin film of liquid is formed on the bounding walls. In a microchannel with a rectangular cross section, the liquid in the film leaks towards the low-pressure corners of the geometry, which leads to the appearance of local minima in the film thickness in the cross-sectional plane. In such a configuration, theory suggests that the minimum film thickness scales with Ca and Ca(4/3) depending on the distance from the nose of the bubble, where Ca = μUb/γ is the flow capillary number based on the bubble velocity Ub, liquid viscosity μ and surface tension γ...
December 14, 2017: Langmuir: the ACS Journal of Surfaces and Colloids
https://www.readbyqxmd.com/read/29237135/spontaneous-pneumothorax-in-children-national-management-strategies-and-outcomes
#3
Kibileri Williams, Tolulope A Oyetunji, Grace Hsuing, Richard J Hendrickson, Timothy B Lautz
INTRODUCTION: The timing of surgical intervention in the management of spontaneous pneumothorax remains controversial. The aim of this multicenter review was to compare management strategies and outcomes in children with spontaneous pneumothorax. METHODS: We retrospectively reviewed patients 10-19 years old in the Pediatric Health Information System admitted for spontaneous pneumothorax from 2010 to 2014. Three treatment groups were identified based on initial hospital management-no intervention, initial chest tube placement, and operation; and outcomes were compared...
December 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29234608/location-of-ruptured-bullae-in-secondary-spontaneous-pneumothorax
#4
Jinseok Choi, Hyo Yeong Ahn, Yeong Dae Kim, Hoseok, Jeong Su Cho, Jonggeun Lee
Background: The surgical treatment of secondary spontaneous pneumothorax (SSP) can be complicated by fragile lung parenchyma. The preoperative prediction of air leakage could help prevent intraoperative lung injury during manipulation of the lung. Common sites of bulla development and ruptured bullae were investigated based on computed tomography (CT) and intraoperative findings. Methods: The study enrolled 208 patients with SSP who underwent air leak control through video-assisted thoracoscopic surgery (VATS)...
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29231090/esophageal-dysmotility-in-patients-following-total-laryngectomy
#5
Teng Zhang, Julia Maclean, Michal Szczesniak, Paul P Bertrand, Harry Quon, Raymond K Tsang, Peter I Wu, Peter Graham, Ian J Cook
Objectives Dysphagia is common in total laryngectomees, with some symptoms suggesting esophageal dysmotility. Tracheoesophageal (TE) phonation requires effective esophagopharyngeal air passage. Hence, esophageal dysmotility may affect deglutition or TE phonation. This study aimed to determine (1) the characteristics of esophageal dysmotility in laryngectomees, (2) whether clinical history is sensitive in detecting esophageal dysmotility, and (3) the relationship between esophageal dysmotility and TE prosthesis dysfunction...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29223424/outcome-after-lung-volume-reduction-surgery-in-patients-with-severely-impaired-diffusion-capacity
#6
Claudio Caviezel, Nadja Schaffter, Didier Schneiter, Daniel Franzen, Ilhan Inci, Isabelle Opitz, Walter Weder
BACKGROUND: Lung volume reduction surgery (LVRS) has been proven to be a successful procedure and can be performed with low mortality when defined selection criteria are met. We hypothesized good outcome and low mortality after LVRS for selected patients with severe hyperinflation and nonhomogeneous morphology even when diffusion capacity of the lung for carbon monoxide (Dlco) is less than 20%. METHODS: The study included all patients scheduled for LVRS between March 2005 and May 2014 with a preoperative Dlco of less than 20%...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29221735/comparison-of-digital-and-traditional-thoracic-drainage-systems-for-postoperative-chest-tube-management-after-pulmonary-resection-a-prospective-randomized-trial
#7
Kazuya Takamochi, Shuko Nojiri, Shiaki Oh, Takeshi Matsunaga, Kota Imashimizu, Mariko Fukui, Kenji Suzuki
OBJECTIVE: The objective of this study was to evaluate whether a digital thoracic drainage system (group D) is clinically useful compared with a traditional thoracic drainage system (group T) in chest tube management following anatomic lung resection. METHODS: Patients scheduled to undergo segmentectomy or lobectomy were prospectively randomized before surgery to group D or T. A stratification randomization was performed according to the following air leak risk factors: age, sex, smoking status, and presence of emphysema and/or chronic obstructive pulmonary disease...
November 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29221298/the-redax%C3%A2-coaxial-drain-in-pulmonary-lobectomy-a-study-of-efficacy
#8
Ottavio Rena, Sara Parini, Esther Papalia, Fabio Massera, Davide Turello, Guido Baietto, Caterina Casadio
Background: Pleural drainage is required after pulmonary lobectomy to evacuate air-leak and fluid. We compared the performance of the new Redax® Coaxial Drain (CD) (Redax, Mirandola, Italy) with a standard chest tube (CT) in terms of fluid and air-leak evacuation. Methods: Fifty-two patients receiving a 24-F CD under water-seal after pulmonary lobectomy through open surgery or video-assisted thoracic surgery (VATS) were matched according to demographic, clinical and pathological variables with 104 patients receiving a 24-F CT...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29221263/a-prospective-randomized-trial-comparing-homologous-and-autologous-fibrin-sealants-for-the-control-of-alveolar-air-leak
#9
Burcu Kılıç, Ezel Erşen, Ahmet Demirkaya, H Volkan Kara, Nurlan Alizade, Mehlika İşcan, Kamil Kaynak, Akif Turna
Background: Postoperative air leak is a common complication seen after pulmonary resection. It is a significant reason of morbidity and also leads to greater hospital cost owing to prolonged length of stay. The purpose of this study is to compare homologous sealant with autologous one to prevent air leak following pulmonary resection. Methods: A total of 57 patients aged between 20 and 79 (mean age: 54.36) who underwent pulmonary resection other than pneumonectomy (lobar or sublobar resections) were analyzed...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29218675/thoracotomy-versus-video-assisted-thoracoscopic-surgery-vats-in-stage-iii-empyema-an-analysis-of-217-consecutive-patients
#10
Martin Reichert, Bernd Pösentrup, Andreas Hecker, Emmanuel Schneck, Jörn Pons-Kühnemann, Florian Augustin, Winfried Padberg, Dietmar Öfner, Johannes Bodner
BACKGROUND: Pleural empyema is an infectious disease of the chest cavity, with a high morbidity and mortality. According to the American Thoracic Society, pleural empyema gets graduated into three stages, with surgery being indicated in intermediate stage II and chronic stage III. Evidence for the feasibility of a minimally-invasive video-assisted thoracoscopic approach in stage III empyema for pulmonary decortication is still little. METHODS: Retrospective single-center analysis of patients conducted to surgery for chronic stage III pleural empyema from 05/2002 to 04/2014 either by video-assisted thoracoscopic surgery (VATS, n = 110) or conventional open surgery by thoracotomy (n = 107)...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29214063/bronchoscopic-management-of-prolonged-air-leak
#11
REVIEW
Sevak Keshishyan, Alberto E Revelo, Oleg Epelbaum
Bronchopleural fistula (BPF) with prolonged air leak (PAL) is most often, though not always, a sequela of lung resection. When this complication occurs post-operatively, it is associated with substantial morbidity and mortality. Surgical closure of the defect is considered the definitive approach to controlling the source of the leak, but many patients with this condition are suboptimal operative candidates. Therefore there has been active interest for decades in the development of effective endoscopic management options...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29200977/clinical-trial-design-as-a-decision-problem
#12
Peter Müller, Yanxun Xu, Peter F Thall
The intent of this discussion is to highlight opportunities and limitations of utility-based and decision theoretic arguments in clinical trial design. The discussion is based on a specific case study, but the arguments and principles remain valid in general. The example concerns the design of a randomized clinical trial to compare a gel sealant versus standard care for resolving air leaks after pulmonary resection. The design follows a principled approach to optimal decision making, including a probability model for the unknown distributions of time to resolution of air leaks under the two treatment arms, and an explicit utility function that quantifies clinical preferences for alternative outcomes...
May 2017: Applied Stochastic Models in Business and Industry
https://www.readbyqxmd.com/read/29189279/alkalinized-lidocaine-preloaded-endotracheal-tube-cuffs-reduce-emergence-cough-after-brief-surgery-a-prospective-randomized-trial
#13
Papu Nath, Stephan Williams, Luis Fernando Herrera Méndez, Nathalie Massicotte, François Girard, Monique Ruel
BACKGROUND: Alkalinized lidocaine in the endotracheal tube (ETT) cuff decreases the incidence of cough and throat pain on emergence after surgery lasting more than 2 hours. However, alkalinized lidocaine needs 60-120 minutes to cross the ETT cuff membrane; therefore, its usefulness in shorter duration surgery is unknown. This prospective double-blind randomized controlled trial tested the hypothesis that alkalinized lidocaine would reduce the incidence of emergence cough after surgeries lasting <120 minutes...
November 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29186411/late-onset-of-pneumothorax-after-bronchoscopic-lung-volume-reduction-due-to-migration-of-a-nitinol-coil
#14
Francesco Mongelli, Stefano Cafarotti, Matteo Di Giuseppe, Miriam Patella
The use of Endobronchial coils are a relatively new brochoscopic technique for lung volume reduction. They appear to be safe and effective in improving quality of life, reducing morbidity and mortality related to the primary disease, while avoiding the many risks of morbidity and mortality associated with surgery. Nevertheless, some complications, such as pneumothorax, are relatively common in the periprocedural period. We describe a case of pneumothorax that occurred several days after brochoscopic technique for lung volume reduction due to direct perforation of the visceral pleura by a coil...
November 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29185948/pneumopericardium-in-the-neonate
#15
Tiffany L Walker, Dorothy A Shannon
Pneumopericardium occurs when air accumulates in the pericardial sac surrounding the heart and is one of the rarest forms of air leaks in neonates. Because of various advances in neonatal care, including gentler modes of ventilation, surfactant replacement, and antenatal steroids, the incidence of pneumopericardium has decreased. Despite the decrease in incidence of pneumopericardium, most cases arise in premature infants with a history of respiratory distress and mechanical ventilation. Evidence has shown that the incidence is inversely related to birth weight and that pneumopericardium has high mortality and morbidity rates...
November 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/29172236/what-is-the-optimal-management-of-an-intra-operative-air-leak-in-the-colorectal-anastomosis
#16
Jonathan B Mitchem, Caitlin Stafford, Todd D Francone, Patricia L Roberts, David J Schoetz, Peter W Marcello, Rocco Ricciardi
AIM: An air tight anastomosis on intra-operative leak testing has been previously demonstrated to be associated with lower risk of clinically significant post-operative anastomotic leak following left-sided colorectal anastomosis. However, to-date, there is no consistently agreed upon method for management of an intra-operative anastomotic leak. Thus, we powered a non-inferiority study to determine whether suture repair alone was an appropriate strategy for the management of an intra-operative air leak...
November 24, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29166258/application-of-a-skin-adhesive-to-maintain-seal-in-negative-pressure-wound-therapy-demonstration-of-a-new-technique
#17
Murad Karadsheh, Josh Nelson, Benjamin Rechner, Richard Wilcox
Optimal wound healing with negative pressure wound therapy (NPWT) relies on a properly sealed vacuum system. Anatomically difficult wounds impair the adhesive dressing, which results in air leaks that disrupt the integrity of the NPWT system and hinder wound healing. OBJECTIVE: The authors demonstrate a new technique using a cyanoacrylate-based tissue adhesive to maintain an airtight, durable seal in NPWT. MATERIALS AND METHODS: A 52-year-old woman with a degloving injury to the right thigh extending into the groin, resulting in massive necrosis, presented to the emergency department...
November 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29160425/local-and-systemic-effects-of-fibrin-and-cyanoacrylate-adhesives-on-lung-lesions-in-rabbits
#18
Marcus V H Carvalho, Evaldo Marchi, Andre J Fruchi, Bruno V B Dias, Clovis L Pinto, Geovane R Dos Santos, Milena M P Acencio
OBJECTIVES: Tissue adhesives can be used to prevent pulmonary air leaks, which frequently occur after lung interventions. The objective of this study is to evaluate local and systemic effects of fibrin and cyanoacrylate tissue adhesives on lung lesions in rabbits. METHODS: Eighteen rabbits were submitted to videothoracoscopy + lung incision alone (control) or videothoracoscopy + lung incision + local application of fibrin or cyanoacrylate adhesive. Blood samples were collected and assessed for leukocyte, neutrophil and lymphocyte counts and interleukin-8 levels preoperatively and at 48 hours and 28 days post-operatively...
October 2017: Clinics
https://www.readbyqxmd.com/read/29159658/lung-necrosectomy-in-pediatric-patients-with-necrotizing-pneumonia
#19
Francina V Bolaños-Morales, Emmanuel Peña Gómez-Portugal, María E Aguilar-Mena, Patricio J Santillán-Doherty, Avelina Sotres-Vega, J Alfredo Santibáñez-Salgado
INTRODUCTION: Necrotizing pneumonia is the consolidation of lung parenchyma with destruction and necrosis, forming solitary or multiloculated radiolucent foci. When antibiotic treatment fails and clinical course does not improve, patients might need lung tissue resection: segmentectomy, lobectomy or bilobectomy. We have performed a more conservative surgical approach in pediatric patients with necrotizing pneumonia, lung necrosectomy: resection of unviable necrotic tissue, to preserve more healthy and potentially recoverable lung parenchyma...
November 20, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29155978/results-of-repeated-video-assisted-thoracic-surgery-for-recurrent-pneumothorax-after-primary-spontaneous-pneumothorax
#20
Sukki Cho, Sanghoon Jheon, Dong Kwan Kim, Hyeong Ryul Kim, Dong Myung Huh, Sungsoo Lee, Kyoung Min Ryu, Deog Gon Cho
OBJECTIVES: This study aimed to identify the causes of recurrent pneumothorax and to evaluate the results of repeated video-assisted thoracic surgery (VATS) for recurrent pneumothorax after VATS wedge resection for primary spontaneous pneumothorax (PSP). METHODS: A retrospective review was conducted on 188 patients with recurrent PSP, of a population of 1414 patients who underwent VATS wedge resection for PSP. Reoperations were performed when an air leak persisted longer than 3 days after closed thoracostomy, when a visible bulla of greater than 1 cm on high-resolution computed tomography (HRCT) was observed and when rerecurrence took place after other treatments...
November 16, 2017: European Journal of Cardio-thoracic Surgery
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