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Chest tube management

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 dataset that encompasses an entire state cohort of hospitalized patients. METHODS: We queried the Healthcare Cost and Utilization Project (HCUP) New York State Inpatient Database (2009-2014) for patients with primary empyema and subsequent readmissions...
March 14, 2018: Annals of Thoracic Surgery
Marjolaine Morgand, Alexandre Leclercq, Mylène M Maury, Hélène Bracq-Dieye, Pierre Thouvenot, Guillaume Vales, Marc Lecuit, Caroline Charlier
OBJECTIVES: Listeria monocytogenes (Lm) is a foodborne human pathogen responsible for severe infection, including septicemia, neurolisteriosis, maternal-fetal and focal infections. Little is known about Lm-associated respiratory tract or lung infections. METHODS: Retrospective study of culture-proven cases of Lm pleural infections and pneumonia reported to the French National Reference Center 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...
March 13, 2018: Clinical Microbiology and Infection
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
Tim Michael Feenstra, Chris Dickhoff, Jaap Deunk
PURPOSE: Tube thoracostomy is frequently used in thoracic trauma patients. However, there is no consensus on whether low pressure suction or water seal is the optimal method of tube management. Against this background, we performed a systematic review of studies comparing suction and water seal management of chest tubes placed for traumatic chest injuries in adults. Evaluated outcomes are duration of chest tube treatment, length of stay in hospital, incidence of persistent air leak, clotted hemothorax, and the need for (re-)interventions...
March 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Simon Laurent, Olivier Martinet, Helene Cuq, Alain Rind, Philippe Durasnel, Claire Lenne, Renaud Blondé
Stingray injuries to the chest are rare but potentially life-threatening. They may occur in remote areas where advanced emergency healthcare services are unavailable. We describe the case of a 24-year-old man with tension pneumothorax due to a Himantura fai stingray injury to the left chest. The chest wound was unremarkable, with no external bleeding or evidence of a foreign body. Decompression was performed at the scene with an improvised knife procedure and a hollow writing pen, which served as a chest tube...
March 9, 2018: Wilderness & Environmental Medicine
Winnie Hedevang Olesen, Niels Katballe, Jesper Eske Sindby, Ingrid Louise Titlestad, Poul Erik Andersen, Rune Lindahl-Jacobsen, Peter Bjørn Licht
OBJECTIVES: Primary spontaneous pneumothorax frequently recurs after chest tube management. Evidence is lacking whether patients may benefit from surgery following their first episode. METHODS: We performed a multicentre, randomized trial and enrolled young, otherwise healthy patients admitted with their first episode of primary spontaneous pneumothorax and treated using conventional chest tube drainage. Patients underwent high-resolution computed tomography on fully expanded lungs, and using web-based randomization, we assigned patients to continued conservative chest tube treatment or chest tube treatment followed by video-assisted thoracoscopic surgery (VATS) with the resection of bullae/blebs and mechanical pleurodesis...
March 2, 2018: European Journal of Cardio-thoracic Surgery
Manuel F Struck, Johannes K M Fakler, Michael Bernhard, Thilo Busch, Patrick Stumpp, Gunther Hempel, André Beilicke, Sebastian N Stehr, Christoph Josten, Hermann Wrigge
This study aimes to determine the complication rates, possible risk factors and outcomes of emergency procedures performed during resuscitation of severely injured patients. The medical records of patients with an injury severity score (ISS) >15 admitted to the University Hospital Leipzig from 2010 to 2015 were reviewed. Within the first 24 hours of treatment, 526 patients had an overall mechanical complication rate of 26.2%. Multivariate analysis revealed out-of-hospital airway management (OR 3.140; 95% CI 1...
March 5, 2018: Scientific Reports
David A Carver, Alexsander K Bressan, Colin Schieman, Sean C Grondin, Andrew W Kirkpatrick, Rohan Lall, Paul B McBeth, Michael B Dunham, Chad G Ball
INTRODUCTION: Haemothorax following blunt thoracic trauma is a common source of morbidity and mortality. The optimal management of moderate to large haemothoraces has yet to be defined. Observational data have suggested that expectant management may be an appropriate strategy in stable patients. This study aims to compare the outcomes of patients with haemothoraces following blunt thoracic trauma treated with either chest drainage or expectant management. METHODS AND ANALYSIS: This is a single-centre, dual-arm randomised controlled trial...
March 3, 2018: BMJ Open
Adam Z Fink, Terry L Levin, Einat Blumfield, Sheri L Nemerofsky, Mark C Liszewski, Kandi George, Suhas Nafday, Mark Shlomovich, K Allen Eddington, Eliza H Myers, H Michael Ushay
BACKGROUND: In pediatric intensive care units (PICUs) and neonatal intensive care units (NICUs), patient management decisions are sometimes based on preliminary interpretations of radiographs by pediatric intensivists (PIs) before a formal interpretation by a pediatric radiologist (PRs). OBJECTIVE: To quantify and classify discrepancies in radiographic interpretation between PRs and PIs in the PICU and NICU. MATERIALS AND METHODS: This institutional review board-approved multi-institutional prospective study included three PRs and PIs at two PICUs and three NICUs...
February 28, 2018: Journal of the American College of Radiology: JACR
Quoc Tran, Ryo Mizumoto, Daniel Mehanna
INTRODUCTION: Subcutaneous emphysema (SE) is a frequent and often self-limiting complication of tube thoracostomy or other cardiothoracic procedures. On rare occasions, severe and extensive surgical emphysema marked by palpable cutaneous tension, dysphagia, dysphonia, palpebral closure or associated with pneumoperitoneum, airway compromise, "tension phenomenon" and respiratory failure require treatment. PRESENTATION OF CASE: A 67 year old lady presented with a large spontaneous pneumothorax on the background of end-stage chronic obstructive pulmonary disease (COPD) and newly diagnosed lung cancer, developed extensive surgical emphysema following insertion of a chest drain...
February 9, 2018: International Journal of Surgery Case Reports
François Olivier, Sophie Nadeau, Sylvie Bélanger, Anne-Sophie Julien, Edith Massé, Nabeel Ali, Georges Caouette, Bruno Piedboeuf
Background: Minimally invasive surfactant therapy (MIST) is a new strategy to avoid mechanical ventilation (MV) in respiratory distress syndrome. The primary aim of this study was to test MIST as a means of avoiding MV exposure and pneumothorax occurrence in moderate and late preterm infants (32 to 36 weeks' gestational age). Methods: This was a randomized controlled trial including three Canadian centres. Patients were randomized to standard management or to the intervention if they required nasal continuous positive airway pressure of 6 cm H2 O and 35% FiO2 in the first 24 hours of life...
June 2017: Paediatrics & Child Health
Abdullah AlShammari, Aman Inayah, Nasir Ali Afsar, Akram Nurhussen, Amna Siddiqui, Muhammad Lucman Anwer, Sadek Obeidat, Mohammed Khaled Bakro, Tawfik Samer Abu Assale, Eyad Almidani, Abdullah Alsonbul, Sami Alhaider, Ibrahim Bin Hussain, Emad Khadawardi, Muhammad Zafar
OBJECTIVE: To explore the effects of simulation training on paediatric residents' confidence and skills in managing advanced skills in critical care. METHODS: The study was conducted at Alfaisal University, Riyadh, Saudi Arabia, from March to June 2016, and comprised junior residents in paediatrics. All paediatric residents (years 1 and 2) were recruited into two workshops, held one week apart. The first workshop covered lumbar puncture/ cerebrospinal fluid interpretation, oral intubation, bone marrow aspiration, and critical airway management...
February 2018: JPMA. the Journal of the Pakistan Medical Association
Su-Huan Chang, Yi-No Kang, Hsin-Yi Chiu, Yu-Han Chiu
BACKGROUND: The optimal initial treatment approach for pneumothorax remains controversial. This systemic review and meta-analysis investigated the effectiveness of small-bore pigtail catheter (PC) drainage in comparison with that of large-bore chest tube (LBCT) drainage as the initial treatment approach for all subtypes of pneumothorax. METHODS: We systematically searched PubMed and Embase for observational studies and randomized controlled trials published up to October 9, 2017, that compared PC and LBCT as the initial treatment for pneumothorax...
February 13, 2018: Chest
Hasan Fevzi Batirel
Minimally invasive surgical techniques are important in surgical management of thymic pathologies. Traditional access techniques are being replaced with minimally invasive techniques using multiportal or uniportal approach. Adoption of minimally invasive techniques for thymic malignancies has been slow due to long term recurrence concerns. Recent studies show that minimally invasive video-assisted thoracoscopic surgery (VATS) or robotic approach to early stage thymic malignancies are associated with less intraoperative bleeding, lower rate of respiratory complications, shorter chest tube duration and shorter hospital stay...
2018: Journal of Visualized Surgery
Chris Elliot, Ben Marais, Phoebe Williams, Paul Joshua, Sherri Towle, Graham Hart, Karen Zwi
AIM: The aim of this study was to assist clinicians evaluating refugee children for latent tuberculosis infection (LTBI) by comparing paired tuberculin skin test (TST) and Quantiferon Gold In-Tube (QGIT) test results with clinical management decisions and follow-up data in a large cohort of newly arrived refugee children. METHODS: This was a retrospective analysis of all refugee children (<15 years of age) evaluated for LTBI with both TST and interferon-γ release assay between 2007 and 2010 in the Illawarra-Shoalhaven region of New South Wales, Australia...
February 14, 2018: Journal of Paediatrics and Child Health
Elzbieta M Grabczak, Rafal Krenke, Monika Zielinska-Krawczyk, Richard W Light
Although pleural manometry is a relatively simple medical procedure it is only occasionally used to follow pleural pressure (Ppl) changes during a therapeutic thoracentesis and pneumothorax drainage. As some studies showed that pleural pressure monitoring might be associated with significant advantages, pleural manometry has been increasingly evaluated in the last decade. The major clinical applications of pleural pressure measurements include: the prevention of complications associated with large volume thoracentesis, diagnosis and differentiation between various types of an unexpandable lung and a possible prediction of the efficacy of chest tube drainage in patients with spontaneous pneumothorax...
January 31, 2018: Respiratory Medicine
J Matthew Reinersman, Mark S Allen, Shanda H Blackmon, Stephen D Cassivi, Francis C Nichols, Dennis A Wigle, K Robert Shen
BACKGROUND: Persistent air leak can complicate pulmonary resection, and one management option is dismissal with a chest tube in place. This study evaluated the rate of empyema and readmission after dismissal with a chest tube. METHODS: A retrospective review of our prospective database from January 2004 to December 2013 identified 236 patients who were discharged from our institution with an indwelling chest tube and attached one-way valve for air leak. Empyema was defined by leukocytosis or fever and undrained effusion on chest roentgenogram or computed tomography...
February 1, 2018: Annals of Thoracic Surgery
Benjamin Wildman-Tobriner, Brian C Allen, Charles M Maxfield
OBJECTIVE: The purpose of this study was to identify common errors that radiology residents make when interpreting abdominopelvic (AP) computed tomography (CT) while on call, to review the typical imaging findings of these cases, and to discuss strategies for improvement. MATERIALS AND METHODS: AP (or chest, abdomen, pelvis) CTs from 518 weekend senior call shifts (R3 or R4) were retrospectively reviewed. Discrepancies between preliminary and final reports were identified and then rated by whether the miss could impact short-term management...
January 6, 2018: Current Problems in Diagnostic Radiology
Sameh I Sersar, Lamees A Maghrabi
Background Aerodigestive fistulae can be defined as abnormal communications between the gastrointestinal tract and the respiratory tract. Choking after meals, coughing, feeding difficulties, tachycardia, and persistent pneumonia are the main presentations. The aim of our study was to review our experience in the management of 27 cases of acquired aerodigestive fistulae of different types, levels, and management. Methods We conducted a retrospective observational study on 27 cases of fistulae between the respiratory and digestive tracts, which were managed in 2 hospitals in Saudi Arabia in the last 5 years...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
Shilpa Sharma, Biplab Mishra, Amit Gupta, Kapil Dev Soni, Richa Aggarwal, Subodh Kumar
Introduction: Neck and thoracic trauma in children pose unforeseen challenges requiring variable management strategies. Here, we describe some unusual cases. Patients and Methods: Pediatric cases of unusual neck and thoracic trauma prospectively managed from April 2012 to March 2014 at a Level 1 trauma center were studied for management strategies, outcome, and follow-up. Results: Six children with a median age of 5.5 (range 2-10) years were managed...
January 2018: Journal of Indian Association of Pediatric Surgeons
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