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Tension pneumothorax

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https://www.readbyqxmd.com/read/29221298/the-redax%C3%A2-coaxial-drain-in-pulmonary-lobectomy-a-study-of-efficacy
#1
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/29210722/point-of-care-ultrasound-in-the-periarrest-setting-lessons-learned-a-case-report
#2
Peter Juhl-Olsen, Rasmus Aagaard, Anni Nørgaard Jeppesen
Point-of-care ultrasound may elucidate reversible causes of cardiac arrest, and its use is supported by international guidelines in the periarrest setting. We present a case in which the treatment of cardiac arrest caused tension pneumothoraces and cardiac tamponade by pneumopericardium. Both pneumothorax and tamponade were expected to be identified with ultrasound, but were not. Subcutaneous emphysema precluded the diagnosis of pneumothorax. Cardiac imaging was false negative for tamponade, because the latter was caused by air and not fluid...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29207778/delayed-tension-pneumothorax-identification-and-treatment-in-traumatic-bronchial-injury-an-interesting-presentation
#3
Amit Gupta, Amulya Rattan, Sunil Kumar, Vinita Rathi
A 13-year-old girl, who did not receive any treatment for few hours following Road Traffic Injury (RTI), reported to the Casualty Department and found to have patent airway with clinically normal C spine, air-hunger (RR 42/minute), trachea deviated to left, distended neck veins and absent breath sounds on the right side. The chest X-ray she carried, done immediately after the injury, showed right sided tension pneumothorax. She was put on oxygen at 11 L/minute and an Intercostal chest tube drainage (ICD) was inserted on right side...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29188917/-implementation-of-the-hartford-consensus-and-tactical-combat-casualty-care-recommendations-in-emergency-services-a-review-of-the-literature
#4
REVIEW
Carmen Usero-Pérez, Valentín González Alonso, Luis Orbañanos Peiro, José Manuel Gómez Crespo, Sheima Hossain López
Recent terrorist attacks involving active shooters or improvised explosive devices have shown that traditionally sequenced emergency management leads to delays in attending victims and suboptimal outcomes. Tactical medicine, a new concept in prehospital care, emerged from experience attending the wounded in combat zones, where the Tactical Combat Casualty Care (TCCC) recommendations are applied. TCCC targets 3 main causes of preventable death in combat: bleeding from extremities, tension pneumothorax, and airway obstruction...
2017: Emergencias: revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29175909/tension-pneumothorax-and-pneumoperitoneum-after-double-lumen-endotracheal-intubation
#5
Matthijs M den Os, Manouk Vermeulen, Dick Naafs, Lenneke E M Haas
No abstract text is available yet for this article.
November 25, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29175906/traumatic-pneumocephaly-trapped-air-from-where
#6
Azam Basheer, Mohamed Macki, Asim Mahmood
Traumatic pneumocephaly is literally defined as 'air in the head' after trauma. While this phenomenon has been well described in the literature, our case report is unique in describing diffuse pneumocephalus in the subaponeurotic space, subdural space, subarachnoid space, brain and ventricles without a break in the cranial vault: a 26-year-old man fell from a =9 meter scaffolding in a water tower. Following an arduous and delayed extrication, the patient was unresponsive with loss of pulse requiring intubation, cardiopulmonary resuscitation and release of tension pneumothorax with bilateral thoracostomy tubes...
November 25, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29143074/-additional-emergency-medical-measures-in-trauma-associated-cardiac-arrest
#7
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
November 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29105540/mechanically-ventilating-the-severe-asthmatic
#8
Abdullah E Laher, Sean K Buchanan
The management of the critically ill patients with asthma can be rather challenging. Potentially devastating complications relating to this presentation include hypoxemia, worsening bronchospasm, pulmonary aspiration, tension pneumothorax, dynamic hyperinflation, hypotension, dysrhythmias, and seizures. In contrast to various other pathologies requiring mechanical ventilation, acute asthma is generally associated with better outcomes. This review serves as a practical guide to the physician managing patients with severe acute asthma requiring mechanical ventilation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28960428/advantages-of-cardiopulmonary-ultrasound-in-post-cardiopulmonary-resuscitation-tension-pneumothorax
#9
Charles W Lanks, Vanessa Correa
Tension pneumothorax is a life-threatening condition that frequently occurs in the setting of cardiopulmonary resuscitation as a result of positive pressure ventilation and chest compressions. Developing crepitus due to subcutaneous air can severely limit pleural ultrasound (US) views and hinder the diagnosis of pneumothorax by pleural US. Physicians trained in the use of point-of-care US must be familiar with the subcostal cardiac and inferior vena cava views associated with tension pneumothorax. These include a dilated, nondistensible inferior vena cava and hyperdynamic right heart as a result of a reduced preload...
September 29, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28944128/tracheostomy-exchange-resulting-in-rare-combination-of-pneumomediastinum-pneumothorax-massive-pneumoperitoneum-and-subcutaneous-emphysema
#10
Saqib Saeed, Sara Alothman, Ali Safavi, Brian Donaldson, Alexius Ramcharan, Hector DePaz
Tracheostomy tube change is a relatively common and simple procedure once a tract is formed between the skin and the trachea. Regular tracheostomy tube changes decrease the risk of postoperative pulmonary infection and granulation tissue formation. However, serious complications, such as loss of airway, subcutaneous emphysema, and mediastinitis, can occur if the tube exchange is performed inappropriately. We present a rare association of subcutaneous emphysema, tension pneumothorax, pneumomediastinum, and pneumoperitoneum following a tracheostomy tube exchange in a 56-year-old patient who had his tracheotomy placed a month ago...
July 18, 2017: Curēus
https://www.readbyqxmd.com/read/28885662/differential-diagnosis-of-alterations-in-arterial-flow-and-tissue-oxygenation-on-venoarterial-extracorporeal-membrane-oxygenation
#11
Anna Hofer, Sylvia Leitner, Michaela Kreuzer, Jens Meier
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) may be life-saving in several clinical situations, but it is also one of the most invasive therapeutic procedures, with significant potential for life-threatening complications. Pulse pressure waves are typically very small or even absent at the onset of ECMO therapy, and will reappear with the improvement of cardiac function. A low pulse pressure may indicate low cardiac output due to heart failure during sustained ECMO support...
September 5, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28885469/bigger-is-better-comparison-of-alternative-devices-for-tension-hemopneumothorax-and-pulseless-electrical-activity-in-a-yorkshire-swine-model
#12
Matthew L Leatherman, Laura M Fluke, Christian S McEvoy, Douglas M Pokorny, Robert L Ricca, Matthew J Martin, Christopher S Gamble, Travis M Polk
BACKGROUND: Tension pneumothorax is a cause of potentially preventable death in prehospital and battlefield settings and 14-gauge angiocatheter (14G AC) decompression remains the current treatment standard, despite its high incidence of failure. Traumatic pneumothorax is often associated with hemothorax, but 14G AC has no proven efficacy for associated hemothorax. We sought to compare the 14G AC to three alternative devices for treatment of tension hemopneumothorax (t-H/PTX) in a positive-pressure ventilation swine model...
December 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28821227/survey-of-practitioners-competency-for-diagnosis-of-acute-diseases-manifest-on-chest-x-ray
#13
Ghazaleh Mehdipoor, Fatemeh Salmani, Abbas Arjmand Shabestari
BACKGROUND: Chest X-ray (CXR) is a common imaging modality that could impact immediate decision-making for acute chest pathologies. We sought to examine the non-radiologists proficiency of diagnosing acute pathologies manifest on CXR. METHODS: We selected 9 clinical vignettes, each associated with a CXR, wherein only a single acute chest pathology was manifest. We also added a low-risk vignette associated with a normal CXR. We built an electronic survey with the CXR-embedded vignettes and also inquired about the participants' confidence in the diagnosis, and prior exposure to the topics...
August 18, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28780253/biomechanics-of-human-parietal-pleura-in-uniaxial-extension
#14
Luis E Morales Tenorio, Kelsey J Devine, Jayme Lee, Timothy M Kowalewski, Victor H Barocas
Tension pneumothorax, a major preventable cause of battlefield death, often arises from chest trauma and is treated by needle decompression to release trapped air from the pleural cavity. Surgical simulation mannequins are often employed to train medical personnel to perform this procedure properly. Accurate reproduction of the mechanical behavior of the parietal pleura, especially in response to needle penetration, is essential to maximize the fidelity of these surgical simulators. To date, however, the design of pleura-simulating material has been largely empirical and based on subjective practitioner feel rather than on the tissue properties, which have remained unknown...
July 29, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28776420/tension-pneumopericardium-in-a-multiply-injured-child
#15
Holger Rupprecht, Katharina Gaab
Tension pneumopericardium is a rare disease that is very difficult to diagnose. A 3-year old child was run over by a minibus. Computed tomography showed bilateral pneumothorax, multiple rib fractures on both sides, and a hepatic laceration. The massive blunt thoracic trauma caused entrapped air in the pericardium, and a tension pneumoprecordium developed abruptly. We report this unique case of tension pneumopericardium in a child, and the subsequent emergency surgery and damage control measures.
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28763898/-effect-of-single-lumen-endobronchial-tube-and-double-lumen-endobronchial-tube-on-ventilation-and-lung-injury-in-patients-with-esophageal-cancer-undergoing-combined-thoracoscopic-and-laparoscopic-esophagectomy
#16
Y L Sun, Y Bai, T K Li, S G Lü, L Wang, X H Lu
Objective: To investigate the effect of the single lumen endobronchial tube and the double lumen endobronchial tube on ventilation and lung injury in patients with esophageal cancer undergoing combined thoracoscopic and laparoscopic esophagectomy. Methods: Sixty patients with esophageal cancer undergoing combined thoracoscopic and laparoscopic esophagectomy were divided into single lumen endobronchial tube group (D group, n=30) and double lumen endobronchial tube group (S, n=30) according to the random number table...
July 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28752438/-blunt-and-penetrating-thoracic-trauma
#17
B Mühling
In most cases blunt chest trauma leads to fractures of the bony thorax, i. e. ribs. In the case of accompanying hemothorax or pneumothorax initial management consists of chest tube drainage by mini-thoracotomy. Subsequently patients with blunt chest trauma have to be transferred to the intensive care unit as these patients are at risk of pulmonary insufficiency or persistent blood loss via the chest tube. Injury to the great vessels or heart requires trauma care in specialized centers. Penetrating trauma is always surgically treated and the foreign body is removed in the operating room (OR)...
September 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28745853/pneumothorax-in-pediatric-patients-management-strategies-to-improve-patient-outcomes-digest
#18
Matthew Harris, Joshua Rocker, Kathryn H Pade
The clinical presentation of pneumothorax is highly variable. Spontaneous pneumothoraces may present with subtle symptoms when a small air leak is present, but can progress to hemodynamic instability in the setting of tension physiology. The etiologies are broad and the severity can vary greatly. A trauma patient with a pneumothorax may also have the added complexity of other potentially life-threatening injuries. While there is a wealth of evidence-based guidelines for the management of pneumothoraces in the adult literature, the approach to pediatric patients is largely extrapolated from that literature without a significant evidence base...
March 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28740394/a-case-of-iatrogenic-pneumothorax-in-which-chest-tube-placement-could-be-avoided-by-intraoperative-evaluation-with-transthoracic-ultrasonography
#19
Izumi Sato, Hirotsugu Kanda, Megumi Kanao-Kanda, Atsushi Kurosawa, Takayuki Kunisawa
We report a case of iatrogenic pneumothorax in which chest tube placement was avoided by continuous intraoperative evaluation with transthoracic ultrasonography. A 53-year-old man had undergone a subsegmentectomy. While attempting to place a central venous catheter in the right internal jugular vein after the induction of anesthesia, we identified gas absorption during the puncture and suspected a pneumothorax. Chest X-ray revealed an ~5-mm collapse of the right lung apex. Tension pneumothorax was a concern during surgery because of the long-term positive pressure ventilation, but we decided to start the operation without preventative chest tube placement...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28707420/transthoracic-intracardiac-catheters-in-pediatric-cardiac-patients-a-single-center-experience
#20
Kristoffer Beham, Hitendu Dave, Janet Kelly, Bernhard Frey, Maja I Hug, Barbara Brotschi
BACKGROUND: Transthoracic intracardiac catheters are frequently inserted in children during congenital heart surgery for monitoring and vascular access purposes. Their use entails a small potential risk. AIM: We aimed to evaluate both catheter-associated morbidities related to maintenance and removal of transthoracic intracardiac catheters in pediatric cardiac patients, and predictors for catheter-associated adverse events. METHODS: Single-center retrospective cohort study of prospectively collected data of children aged 0-14 years receiving a transthoracic intracardiac catheter inserted in the operating room during 7 consecutive years at the University Children's Hospital Zurich...
September 2017: Paediatric Anaesthesia
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