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Chest tube management

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https://www.readbyqxmd.com/read/28814258/management-of-complicated-pneumonia-in-childhood-a-review-of-recent-literature
#1
John B Darby, Amrita Singh, Ricardo Quinonez
BACKGROUND: Despite declining rates of community acquired pneumonia (CAP) in children, complicated pneumonia has been on the rise in the last two decades. The management of complicated pneumonia is challenging and continues to be an area of investigation. Despite recently published guidelines, many gaps exist and recent studies attempt to answer challenging questions. OBJECTIVE: To review recently published literature to inform the clinician on the most up to date management of complicated pneumonia in children...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28795034/chemical-pleurodesis-using-doxycycline-and-viscum-album-extract
#2
Kyung Sub Song, DongYoon Keum, Jae Bum Kim
BACKGROUND: In chemical pleurodesis for managing pulmonary air leak, tetracycline derivatives are commonly used, and their effectiveness has been established in many studies. Recently, a Viscum album extract was used in chemical pleurodesis. We compared the effects of V. album with those of a tetracycline derivative (doxycycline) to demonstrate the therapeutic effectiveness of the V. album extract in chemical pleurodesis for managing pulmonary air leak. METHODS: Between October 2010 and October 2016, chemical pleurodesis was performed using doxycycline in 40 patients and the V...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28790290/-postoperative-intrathoracic-hemorrhage-perioperative-prevention-and-management
#3
Yoshimasa Maniwa
Postoperative intrathoracic hemorrhage is sometimes diagnosed in the thoracic cavity, while the patient is in the recovery room after undergoing thoracic surgery such as lung resection with thoracotomy or mediastinal surgery with a median sternotomy. The information from the chest tube is important to identify this kind of postoperative complication. When the condition becomes severe, the patient may develop hemorrhagic shock due to hemothorax and re-exploration to assess for bleeding and hemostasis may be required...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790289/-management-of-chest-drain-after-lung-resection
#4
Satoshi Muto, Hiroyuki Suzuki
The aims of chest drainage after pulmonary resection are to evacuate fluid and air that accumulate in the pleural space and to obtain information on problems such as air leakage and postoperative bleeding. Although suction or water seal drainages are commonly used procedures, the use of digital monitoring system (Thopaz) is gaining popularity as an alternative of the procedures. We need to pay attention to postoperative hemorrhage, chylothorax, infection, and air leakage. Chest X-ray is essential to check the position of the drainage tube and lung expansion...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28776940/evaluation-of-a-digital-drainage-system-thopaz-in-over-250-cases-at-a-single-site-a-retrospective-case-control-study
#5
Hiromasa Arai, Michihiko Tajiri, Yohei Kameda, Kimihisa Shiino, Kohei Ando, Koji Okudela, Munetaka Masuda
Purpose The aim of this study was to evaluate the efficacy of the Thopaz system, a new drainage system in management of general thoracic surgery, based on a review of our clinical practice and a comparison of the utility of the Thopaz device compared with a standard drainage system. Methods A review of 540 thoracic surgeries at our hospital was performed. These cases were divided into 275 treated with the Thopaz system from April 2014 to March 2015, and 265 treated with a standard system from April 2013 to March 2014...
August 4, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28765351/place-atrium-to-water-seal-paws-assessing-wall-suction-versus-no-suction-for-chest-tubes-after-open-heart-surgery
#6
Tamara Kruse, Sharon Wahl, Patricia Finch Guthrie, Sue Sendelbach
BACKGROUND: Traditionally chest tubes are set to -20 cm H2O wall suctioning until removal to facilitate drainage of blood, fluid, and air from the pleural or mediastinal space in patients after open heart surgery. However, no clear evidence supports using wall suction in these patients. Some studies in patients after pulmonary surgery indicate that using chest tubes with a water seal is safer, because this practice decreases duration of chest tube placement and eliminates air leaks. OBJECTIVE: To show that changing chest tubes to a water seal after 12 hours of wall suction (intervention) is a safe alternative to using chest tubes with wall suction until removal of the tubes (usual care) in patients after open heart surgery...
August 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28752438/-blunt-and-penetrating-thoracic-trauma
#7
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/28741012/management-of-computed-tomography-detected-pneumothorax-in-patients-with-blunt-trauma-experience-from-a-community-based-hospital
#8
Ashraf F Hefny, Fathima T Kunhivalappil, Nikolay Matev, Norman A Avila, Masoud O Bashir, Fikri M Abu-Zidan
INTRODUCTION: With near-routine use of computed tomography (CT) for imaging trauma patients, the diagnosis of pneumothorax, especially occult pneumothorax, has increased. However, the need for chest tube insertion remains controversial. We aimed to study the management of pneumothorax detected on CT among patients with blunt trauma, including the decision for tube thoracostomy, in a community-based hospital. METHODS: Chest CT scans of patients with blunt trauma treated at Al Rahba Hospital, Abu Dhabi, from October 2010 to October 2014 were retrospectively studied...
July 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740682/combined-analgesic-treatment-of-epidural-and-paravertebral-block-after-thoracic-surgery
#9
Yujiro Yokoyama, Takahiro Nakagomi, Daichi Shikata, Taichiro Goto
In pulmonary surgical practice, appropriate pain management after thoracotomy is essential for patient recovery and the prevention of complications. Although epidural analgesia (EPI) has been established for chest surgery, it has some limitations and contraindications. Recently, paravertebral block (PVB) was reported as a good alternative method with fewer side effects. Despite the significant effects of these two treatments, postoperative pain remains among the greatest patient burdens. In our institution, we apply a combination of epidural and PVBs after thoracic surgery to reduce pain more effectively...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740674/does-the-usage-of-digital-chest-drainage-systems-reduce-pleural-inflammation-and-volume-of-pleural-effusion-following-oncologic-pulmonary-resection-a-prospective-randomized-trial
#10
Michèle De Waele, John Agzarian, Waël C Hanna, Colin Schieman, Christian J Finley, Joseph Macri, Laura Schneider, Terri Schnurr, Forough Farrokhyar, Katherine Radford, Parameswaran Nair, Yaron Shargall
BACKGROUND: Prolonged air leak and high-volume pleural drainage are the most common causes for delays in chest tube removal following lung resection. While digital pleural drainage systems have been successfully used in the management of post-operative air leak, their effect on pleural drainage and inflammation has not been studied before. We hypothesized that digital drainage systems (as compared to traditional analog continuous suction), using intermittent balanced suction, are associated with decreased pleural inflammation and postoperative drainage volumes, thus leading to earlier chest tube removal...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28724308/eus-guided-recanalization-of-complete-gastrointestinal-strictures
#11
Miguel Martínez-Guillén, Joan B Gornals, Claudia F Consiglieri, Josep M Castellvi, Carme Loras
BACKGROUND AND AIM: Complete gastrointestinal strictures are a technically demanding problem. In this setting, an anterograde technique is associated with a high risk of complications and a combined anterograde-retrograde technique requires a prior ostomy. Our aim was to assess the outcome of a first case series for the management of complete gastrointestinal strictures using endoscopic ultrasound (EUS)-guided puncture as a novel endoscopic approach. PATIENTS AND METHODS: This retrospective case-series describes four cases that were referred for treatment of complete benign gastrointestinal strictures, three upper and one lower...
July 14, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28724233/examining-the-impact-of-active-clearance-of-chest-drainage-catheters-on-postoperative-atrial-fibrillation
#12
Samuel St-Onge, Walid Ben Ali, Ismail Bouhout, Denis Bouchard, Yoan Lamarche, Louis P Perrault, Philippe Demers
OBJECTIVE: Postoperative atrial fibrillation (POAF) is one of the most frequent complications encountered after heart surgery, and significantly increases complications and mortality. An obstructed chest tube, leaving unevacuated blood around the heart and lungs, can lead to atrial inflammation, which can trigger POAF. The aim of this study was to assess the effectiveness of chest drainage incorporating an active tube clearance (ATC) system in reducing the rate of POAF. METHODS: This retrospective analysis based on 300 consecutive patients undergoing heart surgery compared 142 patients allocated to an ATC drainage protocol with 158 controls managed with standard chest drainage...
August 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28723800/effects-of-somatostatin-octreotide-treatment-in-neonates-with-congenital-chylothorax
#13
Rong Yin, Rong Zhang, Jin Wang, Lin Yuan, Liyuan Hu, Siyuan Jiang, Chao Chen, Yun Cao
The influence of somatostatin/octreotide treatment on outcomes of neonates with congenital chylothorax remains controversial. We retrospectively reviewed our experience with somatostatin/octreotide therapy in neonates with this very rare disease.Fourteen neonates with congenital chylothorax who were treated with somatostatin (3.5-7 μg/kg/h, before 2016) or octreotide (1-6 μg/kg/h, after January 2016), along with traditional management between 2013 and 2016, were retrospectively reviewed in this observational study...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28705799/rapid-developing-empyema-by-group-f-beta-streptococcus-anginosus-group
#14
Muhammad Azharuddin, Dy Prudence, Prem Shanker Shukla, Ajay Mathur
A 43-year-old male had progressive pleuritic left-sided chest tightness with shortness of breath. He had dental caries and tenderness on palpation of the left lateral chest. Complete blood count showed leucocytosis. CT scan of the chest with pulmonary emboli protocol showed multiple pulmonary nodules and nodular pleural thickening at left posterior lateral pleura. Forty-eight hours post CTPE scan, CT scan of the chest, abdomen and pelvis displayed right lower lobe consolidation and left-sided pleural effusion with superimposed compressive atelectasis...
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28699426/management-of-hemothorax-after-thoracic-endovascular-aortic-repair-for-ruptured-aneurysms
#15
Mila H Ju, Michael J Nooromid, Heron E Rodriguez, Mark K Eskandari
Background Thoracic aortic aneurysm rupture is often a fatal condition. Emergent thoracic endovascular aortic repair (TEVAR) has emerged as a suitable treatment option. Unfortunately, respiratory complications from hemothorax continue to be an important cause of morbidity and mortality even after successful management of the aortic rupture. We hypothesize that early hemothorax decompression after TEVAR for ruptured aneurysms decreases the rate of postoperative respiratory complications. Methods Single-center, retrospective eight-year review of ruptured thoracic aneurysms treated with TEVAR...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28697892/bronchopleural-fistula-after-pneumonectomy-risk-factors-and-management-focusing-on-open-window-thoracostomy
#16
Antonio Mazzella, Alessandro Pardolesi, Patrick Maisonneuve, Francesco Petrella, Domenico Galetta, Roberto Gasparri, Lorenzo Spaggiari
OBJECTIVE: To evaluate principal risk factors and different therapeutic approaches for postpneumonectomy bronchopleural fistula (BPF), focusing on open window thoracostomy (OWT). METHODS: We retrospectively reviewed all patients treated by pneumonectomy for lung cancer between 1999 and 2014. We evaluated preoperative, operative, and postoperative data; interval between operation and fistula formation; and size, treatment, and predicting factors of BPF. Cumulative incidence curves for the development of BPF were drawn according to the Kaplan-Meier method...
June 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28673640/small-tube-thoracostomy-20-22-fr-in-emergent-management-of-chest-trauma
#17
Shinsuke Tanizaki, Shigenobu Maeda, Makoto Sera, Hideya Nagai, Minoru Hayashi, Hiroyuki Azuma, Ken-Ichi Kano, Hiroki Watanabe, Hiroshi Ishida
BACKGROUND: The optimal tube size for an emergent thoracostomy for traumatic pneumothorax or hemothorax is unknown. Both small catheter tube thoracostomy and large-bore chest tube thoracostomy have been shown to work for the nonemergent management of patients with traumatic pneumothorax or hemothorax. This study was conducted to compare the efficacy of a small chest tube with that of a large tube in emergent thoracostomy due to chest trauma. Our hypothesis was that there would be no difference in clinical outcomes including tube-related complications, the need for additional tube placement, and thoracotomy, with the replacement of large tubes with small tubes...
June 23, 2017: Injury
https://www.readbyqxmd.com/read/28671165/diagnostic-evaluation-of-mediastinal-lesions-analysis-of-144-cases
#18
Ramakant Dixit, Narender Singh Shah, Mukesh Goyal, Chetan B Patil, Mukesh Panjabi, Rakesh C Gupta, Neeraj Gupta, Sabarigiri Vasan Harish
BACKGROUND: Mediastinum is a "Pandora's box" with many neoplastic and nonneoplastic lesions. The purpose of this study was to analyze our institutional experience of mediastinal lesions on fine-needle aspiration cytology (FNAC) and/or biopsy. MATERIALS AND METHODS: This study was an analysis of 144 patients who had undergone ultrasound-guided FNAC and/or core biopsy for mediastinal lesions. RESULTS: A total of 144 cases of suspected mediastinal masses were seen, and in 139 cases, tissue diagnosis was attempted...
July 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28671161/video-assisted-thoracoscopic-surgery-for-pulmonary-aspergilloma
#19
Arvind Kumar, Belal Bin Asaf, Harsh Vardhan Puri, Vijay C Lingaraju, Shireen Siddiqui, Pulle Mohan Venkatesh, Jayashree Sood
INTRODUCTION: Surgical management of pulmonary aspergilloma in symptomatic patients offers a significant chance of cure. Video-assisted thoracic surgery is a valid alternative for properly selected cases. We herein report our experience with thoracoscopic management of pulmonary aspergilloma. PATIENT AND METHODS: This retrospective analysis was performed on 41 patients operated between 2012 to 2015. The patient records were thoroughly analyzed for demography, clinical presentation, computed tomography , the procedure performed , post-operative complications and course during 6 month's follow up...
July 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28660205/pneumothoraces-in-collagen-vi-related-dystrophy-a-case-series-and-recommendations-for-management
#20
Kristin L Fraser, Scott Wong, A Reghan Foley, Sameer Chhibber, Carsten G Bönnemann, Daniel J Lesser, Carla Grosmann, Anne Rutkowski
Collagen VI-related dystrophy (collagen VI-RD) is a rare neuromuscular condition caused by mutations in the COL6A1, COL6A2 or COL6A3 genes. The phenotypic spectrum includes early-onset Ullrich congenital muscular dystrophy, adult-onset Bethlem myopathy and an intermediate phenotype. The disorder is characterised by distal hyperlaxity and progressive muscle weakness, joint contractures and respiratory insufficiency. Respiratory insufficiency is attributed to chest wall contractures, scoliosis, impaired diaphragmatic function and intercostal muscle weakness...
April 2017: ERJ Open Research
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