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Chest tube management

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https://www.readbyqxmd.com/read/29782482/trauma-patients-are-safe-to-fly-72-hours-after-tube-thoracostomy-removal
#1
David Zonies, Joel Elterman, Christopher Burns, Vincent Paul, John Oh, Jeremy Cannon
BACKGROUND: Current recommendations for safe air travel following traumatic pneumothorax are 2-3 weeks after radiographic resolution. These recommendations are based on several small observational studies and expert consensus which cite a theoretical risk of recurrence and hypoxia due to decreased oxygen tension at altitude. We sought to systematically study the timing of chest drain removal after traumatic pneumothorax and risk of recurrence in relation to air travel. METHODS: A retrospective cohort study of consecutively admitted patients who sustained a traumatic chest injury treated with tube thoracostomy over a 5-year period was undertaken...
May 18, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29781330/management-of-pleural-infections
#2
Lucía Ferreiro, José M Porcel, Silvia Bielsa, María Elena Toubes, José Manuel Álvarez-Dobaño, Luis Valdés
The management of infected pleural effusion is complex. Therapeutic resolution requires determining the following: appropriate antibiotic regimen, the need for pleural drainage, the optimal drainage tube size, and the need for intrapleural therapy or surgery. Areas covered: An updating of the latest advances in the management of parapneumonic pleural effusion based on the best evidence available is provided. Expert commentary: The correct management of parapneumonic pleural effusion is based on selecting an antibiotic regimen according to the origin of the pleural infection (community-acquired or nosocomial)...
May 20, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29726546/the-role-of-standard-non-ecg-gated-chest-ct-in-cardiac-assessment-design-and-rationale-of-the-cardiac-pathologies-in-standard-chest-ct-capact-study
#3
Nienke G Eijsvoogel, Babs M F Hendriks, Hugo B Park, Sibel Altintas, Casper Mihl, Barbora Horehledova, Bastiaan L J H Kietselaer, Harry J G M Crijns, Joachim E Wildberger, Marco Das
Modern high-performance computed tomography (CT) scanners with improved scan acquisition times now allow for routine assessment of cardiac pathologies on chest CTs, which can result in numerous incidental cardiac findings. The CaPaCT study, an observer blinded, single-centre study, aims to assess the visibility, management and possible clinical impact of incidental cardiac pathologies that are now becoming visible on standard chest CTs. A total of 217 consecutive patients referred for a chest CT on a high-performance third-generation dual-source CT scanner will be included...
2018: European radiology experimental
https://www.readbyqxmd.com/read/29703561/tension-hydrothorax-emergency-decompression-of-a-pleural-cause-of-cardiac-tamponade
#4
E E Vinck, J C Garzón, T Peterson, R Villarreal, L Cabrera, L Van den Eijnden
INTRODUCTION: A tension hydrothorax is defined as a massive pleural effusion presenting with hemodynamic abnormalities secondary to mediastinal compression. In these patients pleural volume increases intrathoracic pressure to the point of compromising diastolic filling and cardiac output simulating a cardiac tamponade physiology. This is an uncommon yet potentially fatal medical emergency that if left untreated may progress to cardiac arrest. Early detection and rapid intervention of these patients prevents cardiorespiratory collapse...
April 21, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29701376/what-about-having-a-hydropneumothorax-every-month
#5
Sara Lopes, João Maciel, Pedro Cabral Bastos, Paulo Pinho
INTRODUCTION: Endometriosis is a pathological, benign, inflammatory condition characterized by the presence of endometrial glands and stroma outside the uterine cavity, typically in the pelvis. In rare conditions, this estrogen-dependent disease may be extrapelvic, presenting with a variety of symptoms, including Thoracic Endometriosis. METHODS: A 37 year-old woman presented with her third right hydropneumothorax in three months. Her medical history included infertility, an ovarian mass (in study), biliary diskinesia and protein C deficiency...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29690945/a-protocol-to-decrease-postoperative-chylous-effusion-duration-in-children
#6
Melissa M Winder, Aaron W Eckhauser, Claudia Delgado-Corcoran, Randall J Smout, Jennifer Marietta, David K Bailly
OBJECTIVE: Our primary goal was to decrease time to resolution of postoperative chylothorax as demonstrated by total days of chest tube utilisation through development and implementation of a management protocol. METHODS: A chylothorax management protocol was implemented as a quality improvement project at a tertiary-care paediatric hospital in July, 2015. Retrospective analysis was completed on patients aged 0-17 years diagnosed with chylothorax within 30 days of cardiac surgery in a pre-protocol cohort (February, 2014 to June, 2015, n=20) and a post-protocol cohort (July, 2015 to March, 2016, n=22)...
April 25, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29689739/pleuro-pericardial-communication-due-to-pigtail-catheters-in-extreme-preterm-infants-diagnosis-and-intervention
#7
Ranjit I Kylat
Pneumothorax in preterm infants is associated with an increased risk of chronic lung disease, intraventricular hemorrhage and mortality. In mechanically ventilated preterm infants, for the management of tension pneumothorax if needle aspiration is not successful a thoracostomy is needed. In the last two decades management of tension pneumothorax has changed from the use of traditional chest tubes to percutaneous pigtail catheter thoracostomy (PPCT) as the most commonly used technique. When compared to placement of traditional chest tubes, PPCT is touted as being faster requiring, less analgesia and less training for proficiency and having fewer complications...
2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29629206/enhanced-recovery-pathways-in-thoracic-surgery-the-quebec-experience
#8
Julien Hubert, Etienne Bourdages-Pageau, Charles Antoine Paradis Garneau, Catherine Labbé, Paula A Ugalde
Background: Canada has a universal public health system where all resources must be allocated to optimize cost-effectiveness. Rapid diagnostic assessment programs (DAPs) and enhanced recovery protocols (ERPs) may improve timeliness of care and postoperative outcomes and thus reduce costs. The use of DAPs and ERPs in lung cancer patients who undergo lobectomy via video-assisted thoracoscopic surgery (VATS) is still controversial. This study measured the time between preoperative workup and treatment with a DAP and evaluated the impact of an ERP postoperatively in patients with early-stage non-small cell lung cancer (NSCLC) who received a VATS lobectomy...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29615265/update-is-needle-aspiration-better-than-chest-tube-placement-for-the-management-of-primary-spontaneous-pneumothorax
#9
EDITORIAL
Keegan Tupchong
No abstract text is available yet for this article.
March 31, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29607146/erythromycin-poudrage-versus-erythromycin-slurry-in-the-treatment-of-refractory-spontaneous-pneumothorax
#10
Cong-Cong Zhai, Xin-Shan Lin, Zhou-Hong Yao, Qing-Hua Liu, Ling Zhu, Dian-Jie Lin, Yun-Yan Wan
Background: Refractory (recurrent or persistent) spontaneous pneumothorax with high recurrence rates required treatment either by continuous chest drainage or interventional approaches. Pleurodesis by sclerosing agents has become a significant therapy in the treatment of refractory spontaneous pneumothorax (RSP) on account of its high efficiency and safety. However, the efficacy, safety and appropriate mode of administration of intrapleural erythromycin for pleurodesis have not yet been realized in the treatment of RSP...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29605207/persistent-air-leak-review
#11
REVIEW
Kenneth K Sakata, Janani S Reisenauer, Ryan M Kern, John J Mullon
A persistent air leak (PAL) can be caused by either an alveolar-pleural fistula (APF) or bronchopleural fistula (BPF). Complications from PAL lead to an increase in morbidity and mortality, prolonged hospital stay, and higher resource utilization. Pulmonary physicians and thoracic surgeons are often tasked with the difficult and often times frustrating diagnosis and management of PALs. While most patients will improve with chest tube thoracostomy, many will fail requiring alternative bronchoscopic or surgical strategies...
April 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29600069/the-management-of-chemical-pleurodesis-with-viscum-album-in-patients-with-persistent-air-leakage
#12
Jae Bum Park, Song Am Lee, Woo Surng Lee, Yo Han Kim, Jae Joon Hwang
Background: Persistent air leak (PAL) after major pulmonary resection or involved with secondary lung disease is prevalent and associated with significant morbidity. Chemical pleurodesis is a practical therapeutic tool to manage the patients with PAL. Among various sclerosing substances, viscum album (fraxini) is considered effective and safe. The aim of this study was to evaluate the efficacy and safety of viscum album pleurodesis in patients with intractable prolonged air leakage. Methods: Between February 2013 and February 2015, 73 consecutive patients who underwent pleurodesis due to PAL were enrolled in this study...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29600067/effect-of-chest-tube-size-on-pleurodesis-efficacy-in-malignant-pleural-effusion-a-meta-analysis-of-randomized-controlled-trials
#13
Inderpal Thethi, Shokufeh Ramirez, Wei Shen, Dingding Zhang, Maha Mohamad, Upendra Kaphle, Fayez Kheir
Background: Malignant pleural effusion (MPE) develops in approximately 50% of all patients with metastatic cancer. The efficacy of small- vs. large-bore chest tube for pleurodesis in patients with MPE is still not clear. Methods: We performed a meta-analysis to evaluate the efficacy and safety of chest tube size in the management of MPE. A systematic search of Medline (Ovid) and Embase (from 1980 to March 2016) was performed. Randomized clinical trials (RCTs) evaluating the effect of small (≤14 French) vs...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29595651/bronchoscopic-valve-placement-for-the-treatment-of-persistent-air-leaks
#14
Xiaojie Huang, Liren Ding, Hao Xu
Persistent air leaks (PALs) are associated with increased morbidity, prolonged hospital stay, and increased treatment costs. Endobronchial 1-way valves have been recently used as a potential less invasive treatment option. We sought to investigate the effects of valve therapy in treating this condition. The patients with evidence of continuous air leak flow whose chest tubes remained in place for more than 7 days were treated with bronchoscopic closure using 1-way valves. The source of the air leak was identified by the Chartis system...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29581683/an-analysis-of-presentation-pattern-and-outcome-of-chest-trauma-patients-at-an-urban-level-1-trauma-center
#15
Rajasekhar Narayanan, Subodh Kumar, Amit Gupta, Virinder Kumar Bansal, Sushma Sagar, Maneesh Singhal, Biplab Mishra, Sanjeev Bhoi, Babita Gupta, Shivanand Gamangatti, Adarsh Kumar, Mahesh Chandra Misra
Chest trauma is an important public health problem accounting for a substantial proportion of all trauma admissions and deaths. It directly account for 20-25 % of deaths due to trauma. Therefore, this study was conducted to analyze the presentation, patterns, and outcome of chest trauma in a level-1 urban trauma center. It was a prospective observational study of all patients presented with chest trauma to an urban level 1-trauma center over a period of 3 years. Demographic profile, mechanism of injury, injury severity scores (ISS), associated injuries, hospital stay, etc...
February 2018: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29566162/recombinant-activated-factor-vii-is-associated-with-postoperative-thromboembolic-adverse-events-in-bleeding-after-coronary-surgery
#16
Aly Makram Habib, Antonio Maria Calafiore, Marco Cargoni, Massimiliano Foschi, Michele Di Mauro
OBJECTIVES: To evaluate the impact of recombinant activated factor VII (rFVIIa) administration on thromboembolic adverse events (TAEs) in coronary artery bypass grafting (CABG) surgery patients showing postoperative bleeding. METHODS: From January 2004 to May 2015, 180 CABG surgery patients with postoperative bleeding were included in the study. All patients were managed conservatively and 81 (45%) also received rFVIIa. RESULTS: Ten patients developed new TAEs (5...
March 16, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29560073/nasal-cannula-apneic-oxygenation-prevents-desaturation-during-endotracheal-intubation-an-integrative-literature-review
#17
REVIEW
Joshua M Gleason, Bill R Christian, Erik D Barton
Patients requiring emergency airway management may be at greater risk of acute hypoxemic events because of underlying lung pathology, high metabolic demands, insufficient respiratory drive, obesity, or the inability to protect their airway against aspiration. Emergency tracheal intubation is often required before complete information needed to assess the risk of procedural hypoxia is acquired (i.e., arterial blood gas level, hemoglobin value, or chest radiograph). During pre-oxygenation, administering high-flow nasal oxygen in addition to a non-rebreather face mask can significantly boost the effective inspired oxygen...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29550205/current-state-of-empyema-management
#18
Tara R Semenkovich, Margaret A Olsen, Varun Puri, Bryan F Meyers, Benjamin D Kozower
BACKGROUND: Empyema affects up to 65,000 patients annually in the United States. Recent consensus guidelines demonstrate ambiguity about optimal treatment. We examined current treatment practices and outcomes for inpatient treatment of empyema using a comprehensive, longitudinal data set that encompasses an entire state cohort of hospitalized patients. METHODS: We queried the Healthcare Cost and Utilization Project New York State Inpatient Database (2009 to 2014) for patients with primary empyema and subsequent readmissions...
June 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29549058/listeria-monocytogenes-associated-respiratory-infections-a-study-of-38-consecutive-cases
#19
M Morgand, A Leclercq, M M Maury, H Bracq-Dieye, P Thouvenot, G Vales, M Lecuit, C Charlier
OBJECTIVES: Listeria monocytogenes (Lm) is a foodborne human pathogen responsible for severe infections, including septicaemia, neurolisteriosis, and maternal-foetal and focal infections. Little is known about Lm-associated respiratory tract or lung infections. METHODS: We conducted a retrospective study of culture-proven cases of Lm pleural infections and pneumonia reported to the French National Reference Centre for Listeria from January 1993 to August 2016. RESULTS: Thirty-eight consecutive patients with pleural infection (n = 32), pneumonia (n = 5), or both (n = 1) were studied; 71% of these were men...
March 13, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29548652/clinical-features-of-secondary-spontaneous-pneumothorax-complicated-with-silicosis
#20
Norichika Iga, Hideyuki Nishi, Nobukazu Fujimoto, Takumi Kishimoto
BACKGROUND: Few studies have focused on the management of secondary spontaneous pneumothorax (SSP) as a complication of pneumoconiosis. The aim of this study was to investigate the clinical features and therapeutic course of SSP associated with silicosis. METHODS: Between April 2005 and March 2015, 17 patients with silicosis underwent chest tube drainage for SSP in our institution. We retrospectively analyzed patient characteristics, type of treatment, clinical course, rate of recurrence, and survival time, and compared them with those of 30 patients diagnosed with chronic obstructive pulmonary disease (COPD) during the same period...
March 2018: Respiratory Investigation
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