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"Pneumothorax" AND ("Intercostal Catheter" OR "ICC" OR "Drain" OR "Underwater Seal" OR "UWSD" OR "Needle Decompression" OR "Thoracostomy")

Christopher Kelly, Mark Carlberg, Troy Madsen
Spontaneous pneumothorax (SP) is a relatively common pathology in emergency medicine; however, scant information is published regarding SPs developing tension physiology in the literature. Risk factors for spontaneous pneumothorax include smoking, family history, and underlying lung disease such as chronic obstructive lung disease (COPD), cystic fibrosis, tuberculosis, among others. Treatment often involves conservative management, needle aspiration, catheter placement, or tube thoracostomy. Tension pneumothorax, however, is a life threatening condition requiring emergent intervention...
January 2019: American Journal of Emergency Medicine
Dania Nachira, Mahmoud Ismail, Elisa Meacci, Edoardo Zanfrini, Amedeo Iaffaldano, Marc Swierzy, Julianna Englisch, Svea Faber, Ramin Raul Ossami Saidy, Maria Letizia Vita, Venanzio Porziella, Jens C Rueckert, Stefano Margaritora
Background: The role of triportal video-assisted thoracoscopic surgery (VATS) is widely recognized for the treatment of primary spontaneous pneumothorax (PSP). The aim of this study was to assess the effectiveness and the potential advantages of uniportal VATS (U-VATS) for the treatment of PSP compared with triportal VATS. Methods: A total of 104 triportal (n=39) and uniportal (n=65) VATS procedures where performed for the treatment of PSP in two University hospitals...
November 2018: Journal of Thoracic Disease
Amina Saqib, Uroosa Ibrahim, Rabih Maroun
Thoracostomy tubes are indicated for management of air or fluid in the pleural cavity. Pigtail catheters have emerged as an effective and less morbid alternative to traditional large bore chest tubes for evacuation of pleural air or fluid. However, they do not come without complications which commonly include pneumothorax and hemothorax. Rare complications in the literature such as left ventricular penetration, subclavian artery laceration and cerebral air embolism have been reported. We report a case of a 72-year-old male who presented with dyspnea and was found to have a right-sided pleural effusion requiring thoracentesis and subsequent pigtail catheter placement because of re-accumulation of the fluid...
October 2018: Journal of Thoracic Disease
Masego Candy Mokotedi, Lukas Lambert, Lucie Simakova, Michal Lips, Michal Zakharchenko, Jan Rulisek, Martin Balik
Background: Chest drain (CD) migration in the pleural cavity may result in inadequate drainage of pneumothorax. The aim of this study was to assess several parameters that might help in diagnosing CD migration on chest X-ray (CXR). Methods: Patients with a CD inserted from the safe triangle with a subsequent supine CXR and CT scan performed less than 24 hours apart were assessed for CD foreshortening, angle of inclination of the CD, and CD tortuosity. CD foreshortening was expressed as a ratio between CD length measured in coronal plane only and CD length inside the pleural cavity measured on CT...
October 2018: Journal of Thoracic Disease
Toribiong Uchel, Shahniwaz Labana, Stephanie Tancer, Victoria Gonzalez, Daniel Kapadia, Zain Kulairi, Muhammad Kashlan
BACKGROUND Lymphatic circulation in the thorax enters the systemic blood flow at the subclavian vein. Instances where diversion occurs leads to complications such as pleural effusion. A rare complication of lymphatic diversion results in fluid accumulation in the bronchial tree, causing plastic bronchitis. The following case is the first ever report of plastic bronchitis presenting with pneumopericardium. CASE REPORT A 24-year-old female presented to our Emergency Department with an asthma exacerbation. After initiating bronchodilators, a chest radiograph (CXR) showed extensive subcutaneous emphysema, pneumomediastinum, and pneumothorax with atelectasis of the left lung...
December 3, 2018: American Journal of Case Reports
Ilhan Ocakcioglu, Mustafa Kupeli
PURPOSE: A primary spontaneous pneumothorax is a condition that occurs predominantly in young and thin male individuals who do not have any history of underlying lung disease. Various techniques such as pleural abrasion and pleurectomy are used to reduce the recurrence rate, but there exists no consensus among surgeons on which surgical technique offers the lowest risk of recurrence.We aimed to compare the efficiency and recurrence risk of pleural abrasion and pleurectomy methods in patients with primary spontaneous pneumothorax undergoing a wedge resection for the bulleous part of the paranchyme...
November 28, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
M T Tsakok, M W Little, G Hynes, R S Millington, P Boardman, F V Gleeson, E M Anderson
AIM: To determine local control, safety, and survival following percutaneous computed tomography (CT)-guided high-power microwave ablation (MWA) in the treatment of primary lung malignancy at a single institution. MATERIAL AND METHODS: From July 2010 to June 2016, 52 patients (mean age 76.3 years, range 55-91 years) with 61 unresectable primary lung cancers of mean diameter 23.8 mm (range 26-55 mm) underwent MWA in 55 ablation sessions. Tumours were diagnosed at biopsy, or positron-emission tomography (PET) avidity (mean SUV max = 10...
November 14, 2018: Clinical Radiology
Bo Laksáfoss Holbek, Merete Christensen, Henrik Jessen Hansen, Henrik Kehlet, René Horsleben Petersen
OBJECTIVES: The optimal level of suction on digital chest drainage devices after lobectomy using video-assisted thoracoscopic surgery (VATS) is unknown and varies between thoracic centres. In this randomized controlled trial, we assessed the potential benefits of low suction of -2 cmH2O compared to -10 cmH2O, using a digital drainage device. METHODS: Two hundred and twenty-eight patients were randomized into 2 groups after VATS lobectomy for suspected or confirmed lung cancer...
November 15, 2018: European Journal of Cardio-thoracic Surgery
Michal Senitko, Amrik S Ray, Terrence E Murphy, Katy L B Araujo, Kyle Bramley, Erin M DeBiasi, Margaret A Pisani, Kelsey Cameron, Jonathan T Puchalski
BACKGROUND: Pleural effusions may be aspirated manually or via vacuum during thoracentesis. This study compares the safety, pain level, and time involved in these techniques. METHODS: We randomized 100 patients receiving ultrasound-guided unilateral thoracentesis in an academic medical center from December 2015 through September 2017 to either vacuum or manual drainage. Without using pleural manometry, the effusion was drained completely or until the development of refractory symptoms...
November 14, 2018: Journal of Bronchology & Interventional Pulmonology
Azfar K Niazi, Paul Minko, Colin J Nahrstedt, Adam R Morris, Partha J Saha, Kavita Elliott, Tamer Ghaly, Sabry Ayad
Pseudo-pneumothorax occurs after inappropriately diagnosing a pneumothorax based on a chest X-ray. This can be attributed to skin folds, bed sheets, previous pneumothorax, heating blankets, clothes, and other circumstances that may mimic the radiographic findings of a pneumothorax. We present a case where a patient underwent a tube thoracostomy due to the diagnosis of a pneumothorax that was not, in fact, present. The unnecessary intervention was complicated by hemoptysis and cardiac arrest.
September 6, 2018: Curēus
Rob J Hallifax, Magda Laskawiec-Szkonter, Najib M Rahman
The initial treatment regime for primary spontaneous pneumothorax (PSP) is generic and non-personalised, often involving a long hospital stay waiting for air leak to cease. This prospective study of 81 patients with PSP, who required drain insertion, captured daily digital air leak measurements and assessed failure of medical management against prespecified criteria. Patients with higher air leak at day 1 or 2 had significantly longer hospital stay. If air leak was ≥100 mL/min on day 1, the adjusted OR of treatment failure was 5...
October 24, 2018: Thorax
David A Barker, Tonje Trinterud, Jackie L Demetriou
OBJECTIVE: To describe and compare fluoroscopic guidance for placement of wide-bore thoracostomy tubes (FGTT) to traditional, blind placement of thoracostomy tubes (BPTT). STUDY DESIGN: Prospective clinical trial. ANIMALS: Twenty client-owned dogs. METHODS: Dogs requiring medical management of pleural effusion received a BPTT, whereas dogs undergoing postoperative management of pneumothorax and/or pleural fluid after lateral thoracotomy received an FGTT...
November 2018: Veterinary Surgery: VS
Kss Dayananda, V Y Kong, J L Bruce, G V Oosthuizen, G L Laing, P Brysiewicz, D L Clarke
INTRODUCTION: Penetrating thoracic trauma is common and costly. Injuries are frequently and selectively amenable to non-operative management. Our selective approach to penetrating thoracic trauma is reviewed and the effectiveness of our clinical algorithms confirmed. Additionally, a basic cost analysis was undertaken to evaluate the financial impact of a selective nonoperative management approach to penetrating thoracic trauma. MATERIALS AND METHODS: The Pietermaritzburg Metropolitan Trauma Services electronic regional trauma registry hybrid electronic medical records were reviewed, highlighted all penetrating thoracic traumas...
October 5, 2018: Annals of the Royal College of Surgeons of England
Daniel T DeArmond, Nitin A Das, Carlos S Restrepo, Scott B Johnson, Joel E Michalek, Brian S Hernandez
BACKGROUND: Chest tube management protocols, particularly in patients with alveolar-pleural air leak due to recent surgery or trauma, are limited by concerns over safety, especially concerns about rapid and occult development of pneumothorax. A continuous, real-time monitor of pneumothorax could improve the quality and safety of chest tube management. We developed a rat model of pneumothorax to test a novel approach of measuring electrical impedance within the pleural space as a monitor of lung expansion...
November 2018: Journal of Surgical Research
Thomas James Altree, Hubertus Jersmann, Phan Nguyen
A 62-year old man with severe chronic obstructive pulmonary disease developed a persistent air leak from an iatrogenic pneumothorax following Computed Tomography-guided core biopsy of a pulmonary nodule. The pneumothorax was treated with an 8.5F intercostal catheter, which was then replaced by a 28F thoracostomy tube after development of significant subcutaneous emphysema and a tension pneumothorax. The air leak showed no improvement until endobronchial valve (EBV) insertion guided by objective flow data from a digital drainage system (DDS)...
November 2018: Respirology Case Reports
Nathan S Rubalcava, Jenna L Sitenga, Vincent A Gemma, Kevin P McGeever, Ross M Bremner
A 42-year-old man presented to the emergency department with gunshot wound to left upper back over the scapula and palpable bullet over the right supraclavicular fossa. The patient had a left-sided needle thoracostomy in the field. He was tachypneic and tachycardiac but normortensive on arrival. Due to the patient being in respiratory distress, he was orotracheally intubated. On examination, he was found to have a moderate left pneumothorax with mild mediastinal shift. He had a left closed tube thoracostomy placed...
2018: Trauma surgery & acute care open
Conceição Santos, Saurabh Gupta, Melissa Baraket, Peter J Collett, Wei Xuan, Jonathan P Williamson
BACKGROUND: Intercostal chest catheter (ICC) insertion is a common hospital procedure with attendant risks including life-threatening complications such as pneumothorax and visceral damage. OBJECTIVE: To investigate the effect of a quality improvement initiative on complications associated with inpatient thoracostomy tube insertion. METHODS: Following an audit of ICC complications in inpatients over a 2 year period we implemented a comprehensive quality improvement (QI) program...
September 19, 2018: Internal Medicine Journal
Andrew W Kirkpatrick, Jessica L McKee, Itamar Netzer, Paul B McBeth, Scott D'Amours, Volker Kock, Alex Dobron, Chad G Ball, Elon Glassberg
BACKGROUND: Tension pneumothorax is a frequent cause of potentially preventable death. Tube thoracostomy (TT) can obviate death but is invasive and fraught with complications even in experienced hands. We assessed the utility of a remote international virtual network (RIVN) of specialized mentors to remotely guide military medical technicians (medics) using wireless informatics. METHODS: Medics were randomized to insert TT in training mannequins (TraumaMan; Abacus ALS, Meadowbrook, Australia) supervised by RIVN or not...
September 14, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
İbrahim Ulaş Özturan, Nurettin Özgür Doğan, Cansu Alyeşil, Murat Pekdemir, Serkan Yılmaz, Hüseyin Fatih Sezer
Objectives: Traumatic iatrogenic pneumothorax occurs most often after a transthoracic needle biopsy. Since this procedure has become a common outpatient intervention, emergency department admissions of post-biopsy pneumothorax patients have increased. The aim of this study was to determine the factors that predict the need for tube thoracostomy in patients with post-biopsy pneumothorax in the emergency department. Methods: A retrospective cross-sectional study was conducted on 191 patients with post-biopsy pneumothorax who were admitted to the emergency department between 2010 and 2017...
September 2018: Turkish Journal of Emergency Medicine
Shiko Honma, Satoshi Narihiro, Takuya Inagaki, Shuji Sato, Mitsuo Yabe, Hideki Matsudaira, Jun Hirano, Toshiaki Morikawa
The patient was a 74-year-old man who had undergone surgery for rectal cancer 9 years before and had developed left lung metastasis(S3)3 years and 4 months prior to admission. He had received video assisted left lung wedge resection. He presented with a growing nodular lesion close to the remaining left lung margin and elevated serum carcinoembryonic antigen(CEA)levels, and underwent open extended segmentectomy. The chest drain tube was removed on 3rd post-operative day, but he developed left pneumothorax on 4th post-operative day and a computed tomography(CT)scan revealed a cystic lesion 5...
August 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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