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Tension pneumothorax

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https://www.readbyqxmd.com/read/28960428/advantages-of-cardiopulmonary-ultrasound-in-post-cardiopulmonary-resuscitation-tension-pneumothorax
#1
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
#2
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
#3
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
#4
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 pre-hospital and battlefield settings and 14g 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...
September 5, 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
#5
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
#6
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
#7
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
#8
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
#9
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)...
July 27, 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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28674910/diagnostic-imaging-in-pediatric-thoracic-trauma
#13
Claudia Lucia Piccolo, Stefania Ianniello, Margherita Trinci, Michele Galluzzo, Michele Tonerini, Massimo Zeccolini, Giuseppe Guglielmi, Vittorio Miele
Thoracic trauma accounts for approximately 14% of blunt force traumatic deaths, second only to head injuries. Chest trauma can be blunt (90% of cases) or penetrating. In young patients, between 60 and 80% of chest injuries result from blunt trauma, with over half as a consequence of impact with motor vehicles, whereas in adolescents and adults, penetrating trauma has a statistically more prominent role. Pulmonary contusions and rib fractures are the most frequent injuries occurring. Chest X-ray is the first imaging modality of choice to identify patients presenting with life-threatening conditions (i...
July 4, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28614862/-thoracic-trauma-prehospital-treatment
#14
Michael Hansen, Thomas Hachenberg
Penetrating thoracic injuries are rare in Germany and common in urban regions. 10 percent of the patients in Emergency Departments suffer from blunt thoracic trauma. Mechanism of trauma can predict the severity of the injuries. Very fast life-threatening injuries with hemodynamic problems like tension pneumothorax or cardiac tamponade have to be diagnosed. Prehospital emergency physicians need skills in ultrasound for diagnosis and in invasive therapy like chest tube or pericardium drainage tube. The application of an algorithm in exploration of a thoracic trauma seems to be useful...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28604085/tension-pneumothorax-after-percutaneous-tracheostomy
#15
Sarina Matsumura, Naotaka Kishimoto, Tomio Iseki, Yoshihiro Momota
A 76-year-old woman with right mandibular gingival cancer was scheduled for surgery. A percutaneous tracheostomy kit was used for tracheostomy under intravenous sedation. After puncturing the cricothyroid membrane, a dilator was inserted along a guidewire. Bucking was observed at the time of insertion of the dilator, despite intratracheal lidocaine spray applied before insertion. After that, the tracheostomy tube was inserted, but no capnographic waveforms appeared when the tube was connected to the anesthesia circuit...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28602180/evaluation-of-monaldi-s-approach-with-regard-to-needle-decompression-of-the-tension-pneumothorax-a-cadaver-study
#16
G M Hohenberger, A Schwarz, F Hohenberger, T Niernberger, R Krassnig, N Hörlesberger, A H Weiglein, V Matzi
BACKGROUND: Although needle decompression of tension pneumothorax through the second intercostal space in the midclavicular line (Monaldi's approach) is a life-saving procedure, severe complications have been reported after its implementation. We evaluated the procedure by comparing how it was performed on cadavers by study participants with different training levels. METHODS: Six participants including one thoracic surgeon performed bilateral thoracic drainage after Monaldi on 82 torsos...
September 2017: Injury
https://www.readbyqxmd.com/read/28595214/case-image-extreme-left-diaphragm-displacement-in-the-context-of-tension-pneumothorax-after-cardiac-surgery
#17
María Elena Arnáiz-García, Ana María Arnáiz-García, Jose María González-Santos, Javier López-Rodríguez, Javier Arnáiz
No abstract text is available yet for this article.
June 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28555810/reduced-right-ventricular-diameter-during-cardiac-arrest-caused-by-tension-pneumothorax-a-porcine-ultrasound-study
#18
P Caap, R Aagaard, E Sloth, B Løfgren, A Granfeldt
INTRODUCTION: Advanced life support (ALS) guidelines recommend ultrasound to identify reversible causes of cardiac arrest. Right ventricular (RV) dilatation during cardiac arrest is commonly interpreted as a sign of pulmonary embolism. The RV is thus a focus of clinical ultrasound examination. Importantly, in animal studies ventricular fibrillation and hypoxia results in RV dilatation. Tension pneumothorax (tPTX) is another reversible cause of cardiac arrest, however, the impact on RV diameter remains unknown...
August 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28539992/bi-directional-hepatic-hydrothorax
#19
Madhan Nellaiyappan, Anastasios Kapetanos
A 59-year-old male with alcoholic cirrhosis presented to our hospital with an acutely painful umbilical hernia, and 4 mo of exertional dyspnea. He was noted to be tachypneic and hypoxic. He had a massive right sided pleural effusion with leftward mediastinal shift and gross ascites, with a tense, fluid-filled, umbilical hernia. Emergent paracentesis with drain placement and a large volume thoracentesis were performed. Despite improvement in dyspnea and drainage of 15 L of ascitic fluid, the massive transudative pleural effusion remained largely unchanged...
May 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28539373/bet-2-pre-hospital-finger-thoracostomy-in-patients-with-chest-trauma
#20
Pritchard Jodie, Hogg Kerstin
A short cut review was carried out to see if 'finger' thoracostomy is a safe and effective method of treating a tension pneumothorax in a pre-hospital setting. Five relevant papers were found looking at this technique in the pre-hospital setting. The author, date and country of publication, patient group studied, study type, relevant outcomes, results study weaknesses of these papers are tabulated. This technique appears to be safe and effective when performed by trained physicians in a pre-hospital setting...
June 2017: Emergency Medicine Journal: EMJ
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