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https://www.readbyqxmd.com/read/28500086/detection-of-pneumothoraces-in-patients-with-multiple-blunt-trauma-use-and-limitations-of-efast
#1
Thomas C Sauter, Simon Hoess, Beat Lehmann, Aristomenis K Exadaktylos, Dominik G Haider
BACKGROUND: Extended focused assessment with sonography for trauma (eFAST) has been shown to have moderate sensitivity for detection of pneumothorax in trauma. Little is known about the location or size of missed pneumothoraces or clinical predictors of pneumothoraces in patients with false-negative eFAST. METHODS: This retrospective cross-sectional study includes all patients with multiple blunt trauma diagnosed with pneumothorax who underwent both eFAST and CT performed in the ED of a level 1 trauma centre in Switzerland between 1 June 2012 and 30 September 2014...
May 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28499514/tension-pneumothorax-decompression-with-needle-thoracostomy-colorimetric-capnography
#2
Nimesh D Naik, Matthew C Hernandez, Jeff R Anderson, Erika K Ross, Martin D Zielinski, Johnathon M Aho
BACKGROUND: The success of needle decompression for tension pneumothorax is variable, and there are no objective measures assessing effective decompression. Colorimetric capnography, which detects carbon dioxide present within the pleural space, may serve as a simple test to assess effective needle decompression. METHODS: Three swine underwent traumatically induced tension pneumothorax, (n=15 standard of care, n=15 with needle capnography). Standard of care needle thoracostomy (n=15) using an 8 cm angiocatheter was performed...
May 9, 2017: Chest
https://www.readbyqxmd.com/read/28486386/fluid-overload-and-cumulative-thoracostomy-output-are-associated-with-surgical-site-infection-after-pediatric-cardiothoracic-surgery
#3
Anthony A Sochet, Aoibhinn Nyhan, Michael C Spaeder, Alexander M Cartron, Xiaoyan Song, Darren Klugman, Anna T Brown
OBJECTIVES: To determine the impact of cumulative, postoperative thoracostomy output, amount of bolus IV fluids and peak fluid overload on the incidence and odds of developing a deep surgical site infection following pediatric cardiothoracic surgery. DESIGN: A single-center, nested, retrospective, matched case-control study. SETTING: A 26-bed cardiac ICU in a 303-bed tertiary care pediatric hospital. PATIENTS: Cases with deep surgical site infection following cardiothoracic surgery were identified retrospectively from January 2010 through December 2013 and individually matched to controls at a ratio of 1:2 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery category, primary cardiac diagnosis, and procedure...
May 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28485830/diagnosis-and-management-of-pyothorax-in-a-domestic-ferret-mustela-putorius-furo
#4
Izidora Sladakovic, Benjamin M Brainard, Selena L Lane, Scott A Secrest, Andrew J Fox, Jaime L Tarigo, Corry K Yeuroukis, Susan Sanchez, Laila M Proenca, Joerg Mayer
OBJECTIVE: To describe the diagnosis, management, and outcome of pyothorax in a domestic ferret (Mustela putorius furo). CASE SUMMARY: A domestic ferret was evaluated for a history of lethargy, anorexia, and pyrexia. Pleural effusion was detected with radiography and ultrasonography, and a diagnosis of pyothorax was made following cytologic evaluation of pleural fluid. Bilateral thoracostomy tubes were placed for thoracic drainage and lavage, and the ferret was treated with intravenous crystalloid fluids, antimicrobials, and analgesics...
May 9, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28460565/early-simultaneous-esophagopleural-and-bronchopleural-fistula-after-right-pneumonectomy
#5
Marek Szkorupa, Josef Chudacek, Olga Klementová, Cestmir Neoral, Martin Stasek
BACKGROUND: Esophagopleural and bronchopleural fistulas represent a rare, but life-threatening complication after lung resections, most often after a right pneumonectomy. CASE STUDY: A 64 years old woman was indicated for right pulmectomy for local recurrence of initially stage IIB lung cancer treated by lower lobectomy. On the postoperative day 34, an esophagopleurobronchial fistula occurred. Further course required thoracostomy with closure of the bronchial stump and vacuum-assisted closure therapy and two-phase esophagectomy with 6 weeks interval to the esophageal reconstruction...
May 2, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28460424/video-assisted-thoracic-surgery-for-the-management-of-pyothorax-in-dogs-14-cases
#6
Jacqueline Scott, Ameet Singh, Eric Monnet, Kristin A Coleman, Jeffrey J Runge, Joseph Brad Case, Philipp D Mayhew
OBJECTIVE: To report the perioperative findings and outcome of dogs undergoing video-assisted thoracic surgery (VATS) for the management of pyothorax. DESIGN: Multi-institutional, retrospective study. ANIMALS: Client-owned dogs (n = 14). METHODS: Medical records of dogs with pyothorax managed via VATS were reviewed for signalment, history, clinical signs, clinicopathological findings, diagnostic imaging results, surgical variables, bacterial culture and sensitivity results, post-operative management and outcome...
April 29, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28435901/changes-in-electrocardiographic-findings-after-closed-thoracostomy-in-patients-with-spontaneous-pneumothorax
#7
Wonjae Lee, Yoonje Lee, Changsun Kim, Hyuk Joong Choi, Bossng Kang, Tae Ho Lim, Jaehoon Oh, Hyunggoo Kang, Junghun Shin
OBJECTIVE: We aimed to describe electrocardiographic (ECG) findings in spontaneous pneumothorax patients before and after closed thoracostomy. METHODS: This is a retrospective study which included patients with spontaneous pneumothorax who presented to an emergency department of a tertiary urban hospital from February 2005 to March 2015. The primary outcome was a difference in ECG findings between before and after closed thoracostomy. We specifically investigated the following ECG elements: PR, QRS, QTc, axis, ST segments, and R waves in each lead...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28431130/safety-concerns-with-thoracoabdominal-acupuncture-experience-at-a-tertiary-care-emergency-department
#8
Hak Jin Lee, Youn-Jung Kim, Won Young Kim
Objective.:  To evaluate serious complications caused by acupuncture treatment and to increase awareness of this complication. Design.:  A retrospective observational study. Setting. : At the emergency department of a tertiary hospital in an urban area during a five-year period (2010-2014) in Seoul, Korea. Subjects.:  Patients with postacupuncture mechanical complications in the thoracoabdominal region. Methods...
April 19, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28408233/securing-a-chest-tube-properly-a-simple-framework-for-teaching-emergency-medicine-residents-and-assessing-their-technical-abilities
#9
Raaj K Ruparel, Torrey A Laack, Rushin D Brahmbhatt, Phillip G Rowse, Johnathon M Aho, Yazan N AlJamal, Brian D Kim, David S Morris, David R Farley, Ronna L Campbell
BACKGROUND: Quality-improvement efforts at our institution have identified chest tube dislodgement as a preventable complication of tube thoracostomy. Because proper fixation techniques are not well described in the literature and are seldom formally taught, techniques vary among residents. OBJECTIVE: Our aim was to develop and test a framework for teaching and assessing chest tube securement. METHODS: A repeated-measures study design was used...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28395982/cardiopulmonary-resuscitation-of-out-of-hospital-traumatic-cardiac-arrest-in-qatar-a-nationwide-population-based-study
#10
Furqan B Irfan, Rafael Consunji, Ayman El-Menyar, Pooja George, Ruben Peralta, Hassan Al-Thani, Stephen Hodges Thomas, Guillaume Alinier, Ashfaq Shuaib, Jassim Al-Suwaidi, Rajvir Singh, Maaret Castren, Peter A Cameron, Therese Djarv
BACKGROUND: Traumatic cardiac arrest studies have reported improved survival rates recently, ranging from 1.7-7.5%. This population-based nationwide study aims to describe the epidemiology, interventions and outcomes, and determine predictors of survival from out-of-hospital traumatic cardiac arrest (OHTCA) in Qatar. METHODS: An observational retrospective population-based study was conducted on OHTCA patients in Qatar, from January 2010 to December 2015. Traumatic cardiac arrest was redefined to include out-of-hospital traumatic cardiac arrest (OHTCA) and in-hospital traumatic cardiac arrest (IHTCA)...
March 30, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28391778/delayed-right-chylothorax-after-left-blunt-chest-trauma-a-case-report
#11
Jonggeun Lee, Jeong Su Cho, Hoseok I, Yeong Dae Kim
BACKGROUND: Chylothorax is a disease that has various causes such as neoplasm, infection, post-surgery trauma, congenital, and venous thrombosis. In approximately 15% of cases of chylothorax, the exact cause is unknown. We report a case of delayed occurrence of right chylothorax in a patient who had multiple segmental ribs fracture on his left side. CASE PRESENTATION: A 70-year-old Asian man had a "rollover" accident in which the cultivator he was driving overturned...
April 10, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28370693/computed-tomography-scoring-system-for-discriminating-between-parapneumonic-effusions-eventually-drained-and-those-cured-only-with-antibiotics
#12
José M Porcel, Marina Pardina, Carmen Alemán, Esther Pallisa, Richard W Light, Silvia Bielsa
BACKGROUND AND OBJECTIVE: Due to limited data, we aimed to develop and validate a computed tomography (CT)-based scoring system for identifying those parapneumonic effusions (PPEs) requiring drainage. METHODS: A retrospective review of all patients with PPE who underwent thoracentesis and a chest CT scan before any attempt to place a tube thoracostomy, if applicable, over an 8-year period was conducted. Eleven chest CT characteristics were compared between 90 patients with complicated PPEs (CPPEs), defined as those which eventually required chest drainage, and 60 with non-complicated effusions (derivation sample)...
March 30, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28353306/anatomical-variations-of-the-sternal-angle-and-anomalies-of-adult-human-sterna-from-the-galloway-osteological-collection-at-makerere-university-anatomy-department
#13
Gonzaga Gonza Kirum, Ian Munabi, John Kukiriza, Gerald Tumusiime, Mesach Kange, Charles Ibingira, William Buwembo
BACKGROUND: Anatomical variations of the sternal angle and anomalies of the sternum are unique happenings of major clinical significance.It is known that misplaced sternal angles may lead to inaccurate counting of ribs and create challenges with intercostal nerve blocks and needle thoracostomies. Sternal foramina may pose a great hazard during sternal puncture, due to inadvertent cardiac or great vessel injury. These sternal variations and anomalies are rarely reported among Africans...
March 29, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28351595/congenital-chylothorax
#14
REVIEW
Mohammad A Attar, Steven M Donn
Congenital chylothorax (CC) results from multiple lymphatic vessel anomalies or thoracic cavity defects and may accompany other congenital anomalies. Fetal chylothorax may increase the risk of death and complications from pleural space lymphatic fluid accumulation, which compromises lung development, pulmonary, and cardiovascular function and from complications arising from the loss of drained lymphatic contents. Prenatal interventions might improve survival in severe cases of fetal chylothorax. The neonatal treatment strategy is generally supportive with interventions that include thoracostomy drainage and attempts to decrease chyle flow using a stepwise approach that begins with the least invasive means...
March 25, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28345064/pneumocephalus-in-a-patient-with-multiple-stab-wounds
#15
Yusuf Savran, Volkan Karacam, Basak Bayram, Erdem Yaka, Nuri Karabay
Pneumocephalus is a complication of trauma to the chest and many iatrogenic interventions. It may arise due to systemic air embolism or retrograde cerebral venous air embolism which is an extremely rare complication. We report a 26-years-old female patient who presented to the Emergency Department suffering of multiple stab wounds. She was in a state of shock and after first aid and evaluation she was operated successfully. In the early postoperative period generalized tonic clonic convulsions were observed following cardiopulmonary resuscitation due to sudden cardiovascular collapse...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28342574/ultrasound-findings-in-tension-pneumothorax-a-case-report
#16
Maxine Inocencio, Jeannine Childs, Mikaela L Chilstrom, Kristin Berona
BACKGROUND: Delayed recognition of tension pneumothorax can lead to a mortality of 31% to 91%. However, the classic physical examination findings of tracheal deviation and distended neck veins are poorly sensitive in the diagnosis of tension pneumothorax. Point-of-care ultrasound is accurate in identifying the presence of pneumothorax, but sonographic findings of tension pneumothorax are less well described. CASE REPORT: We report the case of a 21-year-old man with sudden-onset left-sided chest pain...
March 22, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28336238/hydropneumothorax-due-to-esophageal-rupture
#17
Joseph R Shiber, Emily Fontane, Jin H Ra, Andrew J Kerwin
BACKGROUND: A brief review of the historical aspects of esophageal rupture is presented along with a case and current recommendations for diagnostic evaluation and treatment. CASE REPORT: A 97-year-old woman complained of acute dyspnea without prior vomiting. Chest x-ray study showed a large right pneumothorax with associated effusion. A thoracostomy tube was placed with return of > 1 L turbid fluid with polymicrobial culture and elevated pleural fluid amylase level...
March 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28304084/surgical-versus-non-surgical-management-for-pleural-empyema
#18
REVIEW
Mark D Redden, Tze Yang Chin, Mieke L van Driel
BACKGROUND: Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment...
March 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28303679/contralateral-pneumothorax-during-retroperitoneal-laparoscopic-donor-nephrectomy-a-case-report
#19
Yuto Matsushita, Hideaki Miyake, Daisuke Motoyama, Takayuki Sugiyama, Masao Nagata, Atsushi Otsuka, Hiroshi Furuse, Seiichiro Ozono
This report presents a case of a 46-year-old woman in whom contralateral pneumothorax occurred during retroperitoneal laparoscopic donor nephrectomy without any evidence of diaphragmatic injuries. After the start of carbon dioxide-induced pneumoperitoneum, the patient's end-tidal carbon dioxide pressure and heart rate suddenly increased. The surgery was then paused, and a chest X-ray revealed a right pneumothorax accompanied by pneumomediastinum. After a thoracostomy tube was inserted, these symptoms immediately improved...
March 17, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28295572/dyspnea-following-thoracostomy-closure-after-right-pneumonectomy-an-uncommon-echocardiographic-diagnosis-and-therapeutic-approach
#20
Matteo Pernigo, Barbara Canneto, Davide Betta, Gionata Molinari, Flavio Ribichini, Guido Zannini, Corrado Vassanelli, Andrea Rossi
Dyspnea and hypoxemia are common postoperative problems after pneumonectomy. One of the rarer causes of respiratory distress after right pneumonectomy is the development of a significant right-to-left shunt across a patent foramen ovale (PFO), which can evolve at a variable interval of time after the operation. We report here our experience with a patient who underwent right pneumonectomy, followed by several complications, and who presented severe dyspnea 7 months later, after the closure of a right thoracostomy...
March 14, 2017: Echocardiography
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