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

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...
October 10, 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
Joseph D Bozzay, Patrick F Walker, Alley E Ronaldi, Eric A Elster, Carlos J Rodriguez, Matthew J Bradley
The intent of this study was to characterize the management and subsequent complications of combat injury tube thoracostomies and to determine risk factors for the development of pneumonia (PNA) and retained hemothorax (RH). One hundred fifteen patients with 173 tube thoracostomies met the inclusion criteria and were analyzed. The mean injury severity score was 30.8 + 11.6, 23.5 per cent had traumatic amputations, 49.7 per cent had a hemothorax, and 50.3 per cent had a pneumothorax as indications for tube thoracostomy (TT) placement...
August 1, 2018: American Surgeon
Alqasem Fuad H Al Mosa, Mohammed Ishaq, Mohamed Hussein Mohamed Ahmed
Chest tube malpositioning is reported to be the most common complication associated with tube thoracostomy. Intraparenchymal and intrafissural malpositions are the most commonly reported tube sites. We present a case about a 21-year-old patient with cystic fibrosis who was admitted due to bronchiectasis exacerbation and developed a right-sided pneumothorax for which a chest tube was inserted. Partial initial improvement in the pneumothorax was noted on the chest radiograph, after which the chest tube stopped functioning and the pneumothorax remained for 19 days...
2018: Case Reports in Radiology
Naohiro Nose, Hiroki Mori, Akihiro Yonei, Ryo Maeda, Takanori Ayabe, Masaki Tomita, Kunihide Nakamura
A 45-year-old woman was referred to our hospital with sudden chest pain. She came on foot with normal vital signs. Computed tomography (CT) revealed right mild pneumothorax with niveau level. We suspected spontaneous hemopneumothorax (SHP) and inserted a thoracic drain. After 800 ml of blood and air was evacuated immediately, the outflow from the drain stopped. However, despite the outflow of blood from the drainage tube having stopped, she developed hemorrhage shock 2 h after drainage. Contrast-enhanced CT revealed extra-vascular signs at the top of the right pleural cavity...
August 2018: Journal of Surgical Case Reports
P Finnegan, M Fitzgerald, D Smit, K Martin, J Mathew, D Varma, A Lim, S Scott, K Williams, Y Kim, B Mitra
BACKGROUND: Complications related to incorrect positioning of tube thoracostomy (TT) have been reported to be as high as 30%. The aim of this study was to assess the feasibility of flexible videoscope guided placement of a pre-loaded chest tube, permitting direct intrapleural visualization and placement (Video-Tube Thoracostomy [V-TT]). METHODS: A prospective, single centre, phase 1 pilot study with a parallel control group was undertaken. The population studied were adult thoracic trauma patients requiring emergency TT who were haemodynamically stable...
August 11, 2018: Injury
Maren Friederike Balks, Jan-Hendrik Gosemann, Ina Sorge, Martin Lacher, Franz Wolfgang Hirsch
We report the case of a 3-year-old boy who presented with an upper respiratory tract infection and severe dyspnea. A chest X-ray revealed a left-sided tension pneumothorax with mediastinal shift and suspected enterothorax. After thoracic computed tomography (CT) scan, a chest tube was inserted, which drained fluid which had the same consistency and color as the one derived from the nasogastric (NG) tube. The boy underwent diagnostic laparoscopy for suspected bowel perforation, which confirmed a left-sided Bochdalek hernia with herniation of the viscera into the chest...
January 2018: European Journal of Pediatric Surgery Reports
Min Soo Kim, Sumin Shin, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Jae Ill Zo, Young Mog Shim, Jong Ho Cho
Background: A method of wound closure using knotless suture material in the chest tube site has been introduced at our center, and is now widely used as the primary method of closing chest tube wounds in video- assisted thoracic surgery (VATS) because it provides cosmetic benefits and causes less pain. Methods: We included 109 patients who underwent VATS pulmonary resection at Samsung Medical Center from October 1 to October 31, 2016. Eighty-five patients underwent VATS pulmonary resection with chest drain wound closure utilizing knotless suture material, and 24 patients underwent VATS pulmonary resection with chest drain wound closure by the conventional method...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
William R Good, Pernille M Christensen, Samantha Herath, Paul Dawkins, Elaine Yap
BACKGROUND: Radial-probe endobronchial ultrasound (radial-EBUS) is becoming an important investigation for peripheral pulmonary lesions (PPLs). A key advantage of radial-EBUS is the favourable risk profile compared with current gold-standard CT-guided biopsy. AIMS: To investigate the diagnostic yield, predictors of positive yield and radial-EBUS safety in a New Zealand institution. We also determined whether molecular analysis was possible on the same tissue samples...
August 8, 2018: Internal Medicine Journal
Rahul Gupta
Context: Pneumoperitoneum is typically a surgical emergency, particularly in neonates. However, pneumoperitoneum can rarely present without gastrointestinal perforation which is known as spontaneous pneumoperitoneum. Aims: This study aims to analyze the outcome of pediatric patients with spontaneous pneumoperitoneum and describe our experience. Settings and Design: A retrospective study performed from January 2014 to May 2017. Materials and Methods: The study included all pediatric patients admitted in a tertiary care institute...
July 2018: Journal of Indian Association of Pediatric Surgeons
Brenton Robinson
Subcutaneous emphysema (SE) is often seen as a sequela of chest tube placement, cardiothoracic surgery, trauma, pneumothorax, infection or malignancy. In most cases SE is self-limited and requires no intervention. Rarely, air can rapidly dissect into subcutaneous tissue planes leading to respiratory distress, patient discomfort and airway compromise. This is a case of a 75-year-old woman that developed massive SE and impending respiratory failure with rapid progression of air into her subcutaneous tissue. In an effort to rapidly stabilize the patient we placed multiple percutaneous angiocatheters into the subfascial space with complete resolution in <24 h...
July 2018: Journal of Surgical Case Reports
Arif Karagöz, Erden Erol Ünlüer, Onur Akçay, Emine Kadioğlu
Primary spontaneous pneumothorax (PSP) is a common cause of presentation to emergency departments and subsequent hospitalization. Patients with large PSP are treated with tube thoracostomy (TT) and followed up with x-rays. In this study, we investigated the efficiency of bedside ultrasound and compared it with x-ray imaging for the clinical follow-up of PSP patients treated with TT.This is a prospective observational study. After ethical committee approval and written informed consent were obtained, patients who were treated with TT because of PSP were screened...
July 17, 2018: Ultrasound Quarterly
Se Hyun Oh, Hui Dong Kang, Sang Ku Jung, Sangchun Choi
Cerebral arterial gas embolism (CAGE) shows various manifestations according to the quantity of gas and the brain areas affected. The symptoms range from minor motor weakness, headache, and confusion to disorientation, convulsions, hemiparesis, unconsciousness, and coma. A 46-year-old man was transferred to our emergency department due to altered sensorium. Immediately after a controlled ascent from 33 m of seawater, he complained of shortness of breath and rigid extremities, lapsing into unconsciousness...
September 2018: Therapeutic Hypothermia and Temperature Management
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