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Chest tube management

Rifat Latifi, Jayleen K L Gunn, John A Stroster, Edmond Zaimi, Fatos Olldashi, Agron Dogjani, Mihal Kerci, Xheladin Draçini, Julian Kuçani, Zhaneta Shatri, Agim Kociraj, Arian Boci, Ross I Donaldson
BACKGROUND: Traumatic injuries have become a substantial but neglected epidemic in low- and middle-income countries (LMICs), but emergency rooms (ERs) in these countries are often staffed with healthcare providers who have minimal emergency training and experience. The aim of this paper was to describe the specialized training, available interventions, and the patient management strategies in the ERs in Albanian public hospitals. METHODS: A cross-sectional descriptive study of 42 ERs in the Republic of Albania between September 5, 2014, and December 29, 2014 was performed...
December 2016: International Journal of Emergency Medicine
Jessica Hellyer, Hunter Oliver-Allen, Majid Shafiq, Alisha Tolani, Maurice Druzin, Michael Jeng, Stanley Rockson, Robert Lowsky
Introduction Gorham-Stout Disease (GSD) is a rare disorder of bony destruction due to lymphangiomatosis, and is often triggered by hormones. One complication of GSD is the development of chylothorax, which carries a high mortality rate. Very little experience has been published to guide management in GSD during pregnancy to optimize both fetal and maternal health. Case Study A 20-year-old woman with known GSD presented with shortness of breath at 18 weeks of pregnancy, due to bilateral chylothoraces which required daily drainage...
October 2016: American Journal of Perinatology Reports
Ian Smith, Bronwyn L Pearse, Daniel J Faulke, Rishen Naidoo, Lisa Nicotra, Peter Hopkins, Elizabeth G Ryan
OBJECTIVE: Lung transplantation is associated with high rates of bleeding and frequent blood transfusion. The authors aimed to determine if point-of-care coagulation testing (POCCT) reduced transfusion requirements. DESIGN, SETTINGS, AND PARTICIPANTS: A before-and-after cohort analysis conducted at a single tertiary referral center. Ninety-three sequential adult patients between January 2010 and January 2014 undergoing isolated lung transplant without preoperative extracorporeal support were analyzed...
June 27, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Naomi Kebba, Tom Mwambu, Michael Oketcho, Jonathan Izudi, Ekwaro A Obuku
BACKGROUND: There is clinical equipoise regarding post-operative management of patients with patent ductus arteriosus (PDA) without insertion of a chest drain. This study evaluated post operative outcomes of chest closure with or without a drain following Patent Ductus Arteriosus ligation among childen at Uganda Heart Instritute (UHI). METHODS: This was an open label randomized controlled trial of 62 children 12 years of age and below diagnosed with patent ductus arteriosus at Mulago National Teaching and Referral Hospital, Uganda...
September 29, 2016: BMC Surgery
Charles Bakhos, Peter Doelken, Stevan Pupovac, Ashar Ata, Tom Fabian
BACKGROUND: Prolonged pulmonary air leaks (PALs) are associated with increased morbidity and extended hospital stay. We sought to investigate the role of bronchoscopic placement of 1-way valves in treating this condition. METHODS: We queried a prospectively maintained database of patients with PAL lasting more than 7 days at a tertiary medical center. Main outcome measures included duration of chest tube placement and hospital stay before and after valve deployment...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Mohammed Aldahmashi, Mohamed Alassal, Ibrahim Kasb, Hany Elrakhawy
Background. Hydatid cyst (HC) disease is endemic in many developing countries, like Yemen, Egypt, and Saudi Arabia, especially in the rural regions. The disease has a variable clinical courses and even might be asymptomatic for many years. Objectives. In giant and large pulmonary hydatid cysts, pulmonary resection is the usual method of surgical treatment. In this study, we aimed to evaluate the lung conservative surgery in treatment of cases with giant and large hydatid lung cysts, as an effective method of management...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
T Potzger, M Ried, H-S Hofmann
UNLABELLED: Parapneumonic pleural effusion (PPE) occurring in early-stage (stage I) pleural empyema (PE) can be managed by chest tube drainage, which should be performed as soon as possible, to achieve re-expansion of the pulmonary parenchyma. Chronic disease leads to fibrin deposits on both pleural surfaces (stage II), followed by a thickened pleura peel (stage III). A trapped or compressed lung can only be released by surgical decortication, which may be performed with a minimally-invasive approach (video-assisted thoracoscopy) or an open technique (thoracotomy)...
September 2016: Zentralblatt Für Chirurgie
Dong Jung Kim, Yoon Chul Shin, Dong Jin Kim, Jun Sung Kim, Cheong Lim, Kay-Hyun Park
OBJECTIVE: This study aimed to investigate the efficiency and safety of resternotomy performed in the intensive care unit (ICU) for emergent bleeding control after cardiac surgery when transport of the patient to the operating room (OR) was unsafe or delayed. METHODS: Medical records were retrospectively reviewed for 101 patients who underwent resternotomy for bleeding control after cardiac surgery between July 2003 and July 2013. A reoperation was performed in the OR for 61 patients (the OR group) and in the ICU for 40 patients (the ICU group)...
September 7, 2016: Journal of Cardiac Surgery
Masanao Kobayashi, Yasuki Asada, Kosuke Matsubara, Shouichi Suzuki, Yuta Matsunaga, Tomonobu Haba, Ai Kawaguchi, Tomihiko Daioku, Hiroshi Toyama, Ryoichi Kato
Adequate dose management during computed tomography is important. In the present study, the dosimetric application software ImPACT was added to a functional calculator of the size-specific dose estimate and was part of the scan settings for the auto exposure control (AEC) technique. This study aimed to assess the practicality and accuracy of the modified ImPACT software for dose estimation. We compared the conversion factors identified by the software with the values reported by the American Association of Physicists in Medicine Task Group 204, and we noted similar results...
September 2, 2016: Radiation Protection Dosimetry
Jeffrey B Riley, Gregory J Schears, Gregory A Nuttall, William C Oliver, Mark H Ereth, Joseph A Dearani
Excessive bleeding and allogeneic transfusion during adult post-cardiotomy venoarterial extracorporeal membrane oxygenation (ECMO) are potentially harmful and expensive. Balancing the inhibition of clotting and distinguishing surgical from non-surgical bleeding in post-operative period is difficult. The sensitivity of coagulation tests including Thromboelastography(®) (TEG) to predict chest tube drainage in the early hours of ECMO was examined with the use of receiver-operating characteristics (ROC). The results are useful to incorporate in clinical evidence-based algorithms to guide management decisions...
June 2016: Journal of Extra-corporeal Technology
Alison Perry, Siew Hwa Lee, Susan Cotton, Catriona Kennedy
BACKGROUND: Head and neck cancer treatment has developed over the last decade, with improved mortality and survival rates, but the treatments often result in dysphagia (a difficulty in swallowing) as a side effect. This may be acute, resolving after treatment, or remain as a long-term negative sequela of head and neck cancer (HNC) treatment. Interventions to counteract the problems associated with dysphagia include swallowing exercises or modification of diet (bolus texture, size), or both...
2016: Cochrane Database of Systematic Reviews
Lam Nguyen Ho, Ngoc Tran Van, Thuong Vu Le
Boerhaave's syndrome is a rare and severe condition with high mortality partly because of its atypical presentation resulting in delayed diagnosis and management. Diagnostic clues play an important role in the approach to this syndrome. Here, we report a 48 year-old male patient hospitalized with fever and left chest pain radiating into the interscapular area. Two chest radiographs undertaken 22 h apart showed a rapidly developing tension hydropneumothorax. The amylase level in the pleural fluid was high...
July 2016: Respirology Case Reports
Malavika Kulkarni, Manjunath Prabhu, Sagar Maddineni
Direct injury to airway is a rare event and also a challenge to anaesthesiologist and surgeon. We present a case report of open tracheal injury with right pneumothorax in a young male following assault with a sharp weapon. In spite of a chest tube in situ, the patient came with collapse of one lung and tachypnoea which required surgical exploration. Lower airway was evaluated by fibre-optic bronchoscopy through the open tracheal wound while he was awake and tracheal tube was passed over the bronchoscope. There was no vascular or oesophageal injury detected...
July 2016: Indian Journal of Anaesthesia
Pier Luigi Filosso, Alberto Sandri, Francesco Guerrera, Andrea Ferraris, Filippo Marchisio, Giulia Bora, Lorena Costardi, Paolo Solidoro, Enrico Ruffini, Alberto Oliaro
Tube thoracostomy is usually the first step to treat several thoracic/pleural conditions such as pneumothorax, pleural effusions, haemothorax, haemo-pneumothorax and empyema. Today, a wide range of drains is available, ranging from small to large bore ones. Indications for an appropriate selection remains yet matter of debate, especially regarding the use of small bore catheters. Through this paper, we aimed to retrace the improvements of drains through the years and to review the current clinical indications for chest drain placement in pleural/thoracic diseases, comparing the effectiveness of small-bore drains vs...
July 2016: Journal of Thoracic Disease
Rui Mao, Peng-Qing Ying, Dong Xie, Chen-Yang Dai, Jun-Yan Zha, Tao Chen, Ge-Ning Jiang, Ke Fei, Chang Chen
BACKGROUND: Bronchopleural fistula (BPF) is an infrequent but life-threatening complication after lung surgery. Tentative closure of the fistula and irrigation have been the conventional treatments, but are also surgically challenging and associated with a considerable failure rate. This study reports on a conservative practice of this difficult issue, in aim to examine its outcomes. METHOD: All enrolled cases were handled consecutively from September 2006 to June 2015...
July 2016: Journal of Thoracic Disease
Zeeshan Ahmed, Pinakin Patel, Suresh Singh, Raj Govind Sharma, Pankaj Somani, Abdul Rauf Gouri, Shiv Singh
INTRODUCTION: Subcutaneous emphysema is a common complication of tube thoracostomy. Though self-limiting, it should be treated when it causes palpebral closure, dyspnea, dysphagia or undue disfigurement resulting in anxiety and distress to the patient. PRESENTATION OF CASE: A 72year old man who was a known case of COPD on bronchodilators developed a large pneumothorax and respiratory distress after a CT guided transthoracic lung biopsy done for a lung opacity (approx...
2016: International Journal of Surgery Case Reports
Masashi Furukawa, Hiroyuki Tao, Toshiki Tanaka, Kazunori Okabe
BACKGROUND: Chylothorax is a relatively rare but well-known complication of thoracic surgery. CASE PRESENTATION: A 70-year-old man underwent right upper and middle bilobectomy and systematic lymph node dissection through a posterolateral thoracotomy for lung cancer. On the second postoperative day, he developed chylothorax that was treated with dietary management and pleurodesis. The discharge diminished and his chest tube was removed on the ninth postoperative day...
2016: Journal of Cardiothoracic Surgery
Ahmet Demirkaya, Ezel Erşen, Burcu Kılıç, Hasan Volkan Kara, Mehlika İşcan, Kamil Kaynak, Akif Turna
INTRODUCTION: The videothoracoscopic approach is minimally invasive with benefits that include less postoperative pain and shorter hospital stay. It is also a safe procedure which can be performed on an outpatient basis. AIM: To determine whether videothoracoscopic sympathicotomy can be performed safely in most patients as an outpatient procedure. MATERIAL AND METHODS: Between July 2005 and October 2015, a total of 92 patients underwent bilateral and single port thoracoscopic sympathicotomy in our department on an outpatient basis...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Susan Walker, Marijana Zubrinic, Christine Massey, Yaron Shargall, Eric Bédard, Gail Darling
BACKGROUND: In a patient population with a limited life expectancy, malignant pleural effusion can significantly impact quality of life (QoL). Different treatment options are available, each with its own effect on QoL. To date, satisfaction with treatment options has not been evaluated. PURPOSE: To evaluate QoL and satisfaction with treatment using patient-reported outcomes for four different treatment strategies. DESIGN: A prospective, cohort study that compared four treatment options: indwelling pleural catheter (IPC); video assisted thoracic surgery (VATS) and IPC; chest tube and talc slurry; and VATS talc poudrage...
July 2, 2016: International Journal of Palliative Nursing
Akira Iyoda, Satoru Ebihara
In chest surgery, minimal invasiveness is an important topic. Video-assisted thoracic surgery and a less radical resection may be effective for decreasing postoperative complications or postoperative mortality rates. Respiratory rehabilitation is useful for preventing postoperative complications, and it is used pre- and postoperatively for patients with lung cancer and chronic obstructive pulmonary disease (COPD) in most hospitals. Although it is well adapted to patients with a lower forced expiratory volume in 1 second, higher stages of COPD, severe emphysematous changes on computed tomography, and performance status ≥2, there are no definitive criteria for rehabilitation...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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