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Thoracostomy

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https://www.readbyqxmd.com/read/27901387/quantification-and-characterization-of-pleural-fluid-in-healthy-dogs-with-thoracostomy-tubes
#1
Germaine C Hung, M Casey Gaunt, Joseph E Rubin, Gregory S Starrak, Sherisse A Sakals
OBJECTIVE To quantify and characterize pleural fluid collected from healthy dogs after placement of a thoracostomy tube (TT). ANIMALS 8 healthy Coonhound-cross dogs (mean ± SD weight, 27.2 ± 1.6 kg). PROCEDURES Thoracic CT of each dog was performed before placement of a TT and daily thereafter for 7 days. Thoracic fluid volume was calculated from CT images. Effusion was aspirated when detected; volume was recorded, and cytologic analysis and bacterial culture were performed. RESULTS Mean ± SD volume of pleural effusion detected by CT was 1...
December 2016: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/27898253/establishing-equipoise-national-survey-of-the-treatment-of-pediatric-para-pneumonic-effusion-and-empyema
#2
Morgan K Richards, Jarod P Mcateer, Todd C Edwards, Lucas R Hoffman, Matthew P Kronman, Dennis W Shaw, Adam B Goldin
BACKGROUND: Despite six randomized trials of various treatments for pediatric para-pneumonic effusion (PPE), management approaches differ. The purpose of this study was to gain insight into opinions on PPE treatment with the goal of designing a definitive trial to generate consensus intervention guidelines. METHODS: To evaluate physician opinions regarding PPE management, we developed a survey based on input from a nationwide, multi-disciplinary advisory group that established content validity...
November 29, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27894507/do-simple-beside-lung-function-tests-predict-morbidity-after-rib-fractures
#3
Christopher A Butts, John J Brady, Sara Wilhelm, Laura Castor, Alicia Sherwood, Abby McCall, John Patch, Pamela Jones, Vicente Cortes, Adrian W Ong
BACKGROUND: We evaluated if incentive spirometry volume (ISV) and peak expiratory flow rate (PEFR) could predict acute respiratory failure (ARF) in patients with rib fractures. METHODS: Normotensive, co-operative patients were enrolled prospectively. ISV and PEFR were measured on admission, at 24 h and at 48 h by taking the best of three readings each time. The primary outcome, ARF, was defined as requiring invasive or noninvasive positive pressure ventilation...
November 19, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27884332/thoracostomy-tube-function-not-trajectory-dictates-reintervention
#4
Nathan W Kugler, Thomas W Carver, Paul Knechtges, David Milia, Lawrence Goodman, Jasmeet S Paul
BACKGROUND: Hemothorax and/or pneumothorax can be managed successfully managed with tube thoracostomy (TT) in the majority of cases. Improperly placed tubes are common with rates near 30%. This study aimed to determine whether TT trajectory affects the rate of secondary intervention. METHODS: A retrospective review of all adult trauma patients undergoing TT placement over a 4-y period was performed. TT trajectory was classified as ideal, nonideal, or kinked-based on anterior-posterior chest x-ray...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27871519/intrapleural-placement-of-a-thoracic-epidural-catheter-in-a-patient-with-spinal-stenosis
#5
Kiran Belani, Mario Montealegre-Gallegos, Brian Ferla, Robina Matyal
Due to the close proximity of the thoracic epidural space and parietal pleura, pleural puncture with intrapleural catheter placement is a potential complication of thoracic epidural anesthesia. The authors present a case of an obese patient with a history of spinal stenosis that underwent thoracotomy. Repeated failed attempts at epidural anesthesia were complicated by intrapleural placement of the catheter. The patient subsequently developed clinical signs of pneumothorax and required urgent thoracostomy.
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27869490/congenital-diaphragmatic-hernia-causing-cardiac-arrest-in-a-30-year-old-woman
#6
H J Manson, Y M Goh, P Goldsmith, P Scott, P Turner
Congenital diaphragmatic hernia (CDH) usually presents in infancy with respiratory failure requiring urgent surgical correction. Mortality in this group of patients remains poor and persistent pulmonary hypertension is a significant contributor. It is therefore rare for patients to reach adulthood undiagnosed. CDH is often identified incidentally in adults but when symptoms arise, they relate to the organ involved, and include gastrointestinal symptoms of dyspepsia and obstruction, as well as respiratory complaints such as dyspnoea...
November 21, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27868100/nephropleural-fistula-effectively-managed-with-serial-thoracentesis-a-case-report
#7
Aaron D Baugh, Eslam Youssef, Syed Shafae Hasan, Nauman Saleem Siddiqui, Haitham Elsamoloty, Khaled Shahrour, Toseef Javaid
Nephropleural fistulae are rare but serious thoracic complications of percutaneous nephrolithotomy (PCNL). Herein, we present the management of a 54-year-old female with a delayed presentation of nephropleural fistula. The role of serial thoracentesis as a safe, less invasive, less painful alternative to tube thoracostomy is highlighted. In select cases, this may represent an attractive management strategy for nephropleural fistula after PCNL.
2016: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/27847063/tough-syndrome-a-report-of-an-early-immediate-postoperative-cause-of-aortocoronary-graft-occlusion
#8
Rahul Dudhani, Anusha Jegatheeswaran, Vivek Rao
Aortocoronary artery bypass grafts are time tested to be effective definitive therapy of symptomatic coronary artery disease since their inception in the 1960s. Over the years, multiple factors have affected the long-term outcome and patency rates of vein grafts. These can be divided into acute, subacute, and delayed categories. The most common causes, respectively, are thrombosis, intimal hyperplasia, and accelerated atherosclerosis. Numerous studies have analyzed postoperative angiographic images to evaluate these phenomena, and medical therapies have been instituted to prevent occlusion of these grafts...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27843762/dangers-of-flying-high-and-diving-low-an-unusual-case-of-dyspnea
#9
Poornima Ramadas, Rumon Chakravarty, Prathik Krishnan, Anupa Nadkarni
Giant bullae are bullae that occupy at least 30 percent of a hemi thorax. This condition can rarely be idiopathic and not usually suspected in young patients with no risk factors. We describe a case of a giant solitary pulmonary bulla in a healthy young female with no known risk factors. 23-year-old female presented to the Emergency department with dyspnea and pleuritic right sided chest pain. She started experiencing these symptoms when she was on a 7-h flight and later experienced similar symptoms when she went scuba diving...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27826770/endobronchial-naso-bronchial-lavage-an-alternative-interventional-treatment-for-post-lobectomy-bronchopleural-fistula
#10
Ye Ning, Hai Huang, Lei Xue, Xuewei Zhao
BACKGROUND AND STUDY AIMS: Post-lobectomy bronchopleural fistula is a rare complication of lung resection surgery, and proper management is crucial for the successful resolution. Most published papers deal with surgical treatment. We report our experience with a new interventional management, endobronchial naso-bronchial lavage (ENBL). The aim of this study was to evaluate the continuing efficacy and safety of this innovative procedure. PATIENTS AND METHODS: From 2002 to 2012, 17 patients who suffered from post-lobectomy bronchopleural fistula were recruited...
November 8, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27787569/-cardiopulmonary-resuscitation-in-cardiac-arrest-following-trauma
#11
B A Leidel, K-G Kanz
For decades, survival rates of cardiac arrest following trauma were reported between 0 and 2 %. Since 2005, survival rates have increased with a wide range up to 39 % and good neurological recovery in every second person injured for unknown reasons. Especially in children, high survival rates with good neurologic outcomes are published. Resuscitation following traumatic cardiac arrest differs significantly from nontraumatic causes. Paramount is treatment of reversible causes, which include massive bleeding, hypoxia, tension pneumothorax, and pericardial tamponade...
October 27, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27776982/percutaneous-thermal-ablation-for-small-cell-lung-cancer-initial-experience-with-ten-tumors-in-nine-patients
#12
Aaron W P Maxwell, Terrance T Healey, Damian E Dupuy
PURPOSE: To evaluate outcomes in a small cohort of patients with local or disseminated small-cell lung cancer (SCLC) who received percutaneous thermal ablation therapy. MATERIALS AND METHODS: Ten biopsy-proven SCLC tumors in 9 consecutive patients (5 men, 4 women; average age, 73.8 y ± 12.4) were retrospectively evaluated. Average tumor sizes were 1.8 cm ± 0.5 and 2.6 cm ± 1.2 among patients with local and disseminated disease, respectively. Microwave and radiofrequency ablation were each used for 5 tumors...
December 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27776948/-what-place-for-the-thoracostomy-thoracmyoplasty-in-the-management-of-the-chronic-pleural-empyema
#13
M Lakranbi, S Rabiou, L Belliraj, I Issoufou, F Z Ammor, J Ghalimi, Y Ouadnouni, M Smahi
INTRODUCTION: The occurrence of empyema after pneumonectomy or in suites with chronic pleural pocket is a dreaded complication. The management is long and difficult. The authors report their experience before this complication including infection control by an emptying of the pleural pocket percutaneous drainage or thoracostomy which will be complemented by a thoracomyoplasty the aim to erase the pleural pocket. MATERIALS AND METHODS: This is a retrospective study conducted between 2009 and 2015 concerning the records of 9 patients treated for empyema or in the aftermath of a lung resection or as part of a chronic pleural pocket and calcific...
October 21, 2016: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/27769303/short-term-and-long-term-outcomes-of-intrathoracic-vacuum-therapy-of-empyema-in-debilitated-patients
#14
Zsolt Sziklavari, Michael Ried, Florian Zeman, Christian Grosser, Tamas Szöke, Reiner Neu, Rudolf Schemm, Hans-Stefan Hofmann
BACKGROUND: This retrospective study analyzed the effectiveness of intrathoracic negative pressure therapy for debilitated patients with empyema and compared the short-term and long-term outcomes of three different intrapleural vacuum-assisted closure (VAC) techniques. METHODS: We investigated 43 consecutive (pre)septic patients with poor general condition (Karnofsky index ≤ 50 %) and multimorbidity (≥ 3 organ diseases) or immunosuppression, who had been treated for primary, postoperative, or recurrent pleural empyema with VAC in combination with open window thoracostomy (OWT-VAC) with minimally invasive technique (Mini-VAC), and instillation (Mini-VAC-Instill)...
October 21, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27752610/tube-thoracostomy-training-with-a-medical-simulator-is-associated-with-faster-more-successful-performance-of-the-procedure
#15
Tae Nyoung Chung, Sun Wook Kim, Je Sung You, Hyun Soo Chung
OBJECTIVE: Tube thoracostomy (TT) is a commonly performed intensive care procedure. Simulator training may be a good alternative method for TT training, compared with conventional methods such as apprenticeship and animal skills laboratory. However, there is insufficient evidence supporting use of a simulator. The aim of this study is to determine whether training with medical simulator is associated with faster TT process, compared to conventional training without simulator. METHODS: This is a simulation study...
March 2016: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27660731/traumatic-rupture-of-a-posterior-mediastinal-teratoma-following-motor-vehicle-accident
#16
Christopher Bell, Fernando Domingo, Ashley D Miller, Jeremiah S Smith, James R Headrick
We report a case of a posterior mediastinal mature cystic teratoma with rupture secondary to blunt chest trauma in a 20-year-old male involved in a motor-vehicle accident. Initial treatment was guided by Advanced Trauma Life Support and a tube thoracostomy was performed for presumed hemothorax. The heterogeneous collection within the thoracic cavity was discovered to be the result of a ruptured cystic mass. Pathologic findings confirmed the mass consistent with a mature cystic teratoma. As mediastinal teratomas are most commonly described arising from the anterior mediastinum, the posterior location of the teratoma described in this report is exceedingly rare...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27647978/management-of-prolonged-pulmonary-air-leaks-with-endobronchial-valve-placement
#17
Charles Bakhos, Peter Doelken, Stevan Pupovac, Ashar Ata, Tom Fabian
BACKGROUND: Prolonged pulmonary air leaks (PALs) are associated with increased morbidity and extended hospital stay. We sought to investigate the role of bronchoscopic placement of 1-way valves in treating this condition. METHODS: We queried a prospectively maintained database of patients with PAL lasting more than 7 days at a tertiary medical center. Main outcome measures included duration of chest tube placement and hospital stay before and after valve deployment...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27635382/pasteurella-multocida-pleural-effusion-a-case-report-and-review-of-literature
#18
Sidharth Navin Jogani, Ramesh Subedi, Amit Chopra, Marc A Judson
We describe a man who developed pleural effusion with Pasteurella multocida, and review the reported literature concerning this entity. We identified 21 such cases, including our own. Most patients with P. multocida pleural effusions are immunocompromised and/or have significant co-morbidities. These effusions are typically complicated parapneumonic effusions that are grossly purulent (87%) with a low pleural fluid pH (mean 6.8), high protein (mean 4.8 g/dl) and high LDH (mean 1911 U/L) and low glucose (28...
2016: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27629501/-chest-decompression-in-emergency-medicine-and-intensive-care
#19
H Drinhaus, T Annecke, J Hinkelbein
Decompression of the chest is a life-saving invasive procedure for tension pneumothorax, trauma-associated cardiopulmonary resuscitation or massive haematopneumothorax that every emergency physician or intensivist must master. Particularly in the preclinical setting, indication must be restricted to urgent cases, but in these cases chest decompression must be executed without delay, even in subpar circumstances. The methods available are needle decompression or thoracentesis via mini-thoracotomy with or without insertion of a chest tube in the midclavicular line of the 2nd/3rd intercostal space (Monaldi-position) or in the anterior to mid-axillary line of the 4th/5th intercostal space (Bülau-position)...
October 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27609120/determination-of-the-chest-wall-thicknesses-and-needle-thoracostomy-success-rates-at-second-and-fifth-intercostal-spaces-a-cadaver-based-study
#20
Can Ozen, Haldun Akoglu, Rifat Ozgur Ozdemirel, Elif Omeroglu, Cigdem Ulubay Ozpolat, Ozge Onur, Yalcin Buyuk, Arzu Denizbasi
INTRODUCTION: The purposes of this study were to measure the chest wall thicknesses (CWTs) at second intercostal space (ICS) mid-clavicular line (MCL) and fifth ICS MAL directly, and compare the actual success rates of needle thoracostomies (NTs) by inserting a 5-cm-long syringe needle. Predictive values of weight, body mass index (BMI) and CWT were also analyzed. MATERIALS AND METHODS: This study included 199 measurements of 50 adult fresh cadavers from both hemithoraces...
August 20, 2016: American Journal of Emergency Medicine
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