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Chest tube management

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https://www.readbyqxmd.com/read/28216863/efficacy-and-safety-of-povidone-iodine-pleurodesis-in-malignant-pleural-effusions
#1
Hadi Kahrom, Manouchehr Aghajanzadeh, Mohammad Reza Asgari, Mahdi Kahrom
INTRODUCTION: Malignant pleural effusion (MPE) is determined by the detection of malignant cells in pleural fluid or pleural tissue. Neoplasm of lung, breast, ovary and lymphoma are the causes of more than 75% of MPE. Pleurodesis is a usual technique in the management of MPE to achieve a symphysis between two layers of the pleura, and various chemical agents have been used in an attempt to produce pleurodesis. With regard to complications and limitations of these sclerosing agents, efficacy and safety of povidone-iodine have been investigated in this study...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28166840/app-based-serious-gaming-for-training-of-chest-tube-insertion-study-protocol-for-a-randomized-controlled-trial
#2
Mirco Friedrich, Christian Bergdolt, Patrick Haubruck, Thomas Bruckner, Karl-Friedrich Kowalewski, Beat Peter Müller-Stich, Michael C Tanner, Felix Nickel
BACKGROUND: Chest tube insertion is a standard intervention for management of various injuries of the thorax. Quick and accurate execution facilitates efficient therapy without further complications. Here, we propose a new training concept comprised of e-learning elements as well as continuous rating using an objective structured assessment of technical skills (OSATS) tool. The study protocol is presented for a randomized trial to evaluate e-learning with app-based serious gaming for chest drain insertion...
February 6, 2017: Trials
https://www.readbyqxmd.com/read/28149550/management-of-acute-postoperative-pain-with-continuous-intercostal-nerve-block-after-single-port-video-assisted-thoracoscopic-anatomic-resection
#3
Ming-Ju Hsieh, Kuo-Cheng Wang, Hung-Pin Liu, Diego Gonzalez-Rivas, Ching-Yang Wu, Yun-Hen Liu, Yi-Cheng Wu, Yin-Kai Chao, Ching-Feng Wu
BACKGROUND: Effective postoperative pain control for thoracic surgery is very important, not only because it reduces pulmonary complications but also because it accelerates the pace of recovery. Moreover, it increases patients' satisfaction with the surgery. In this study, we present a simple approach involving the safe placement of intercostal catheter (ICC) after single port video-assisted thoracoscopic surgery (VATS) anatomic resection and we evaluate postoperative analgesic function with and without it...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28148274/severity-dependent-differences-in-early-management-of-thoracic-trauma-in-severely-injured-patients%C3%A2-analysis-based-on-the-traumaregister-dgu%C3%A2
#4
J Bayer, R Lefering, S Reinhardt, J Kühle, N P Südkamp, T Hammer
BACKGROUND: Major trauma is associated with chest injuries in nearly 50% of multiple injuries. Thoracic trauma is a relevant source of comorbidity throughout the period of multiply-injured patient care and may require swift and well-thought-out interventions in order to avert a deleterious outcome. In this epidemiological study we seek to characterize groups of different thoracic trauma severity in severely injured patients and identify related differences in prehospital and early clinical management...
February 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28144607/clinical-utility-of-chest-computed-tomography-in-patients-with-rib-fractures-ct-chest-and-rib-fractures
#5
Brandon C Chapman, Douglas M Overbey, Feven Tesfalidet, Kristofer Schramm, Robert T Stovall, Andrew French, Jeffrey L Johnson, Clay C Burlew, Carlton Barnett, Ernest E Moore, Fredric M Pieracci
BACKGROUND: Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. OBJECTIVES: The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. METHODS: Retrospective cohort study of blunt trauma patients with rib fractures at a level I trauma center that had both a CXR and a CT chest...
December 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/28138763/-haemoptysis-intensive-care-management-of-pulmonary-hemorrhage
#6
J H Ficker, W M Brückl, J Suc, A Geise
There is a wide spectrum of severities in patients with pulmonary bleeding with a range from mild haemoptysis to severe bleeding with an acute risk of asphyxiation. For the management of acute pulmonary haemorrhage, it is essential to identify the underlying cause in order to initiate a target-oriented or causal therapy. The most common causes of localized pulmonary bleeding are lung cancer as well as infections, anticoagulant therapy or bronchiectasis. Diffuse alveolar haemorrhage is mostly due to pulmonary vasculitis or connective tissue disease, but may also occur in pulmonary metastasis, congestive heart failure, coagulation disorders and from many other causes...
January 30, 2017: Der Internist
https://www.readbyqxmd.com/read/28130577/radiological-evaluation-of-tube-depth-and-complications-of-prehospital-endotracheal-intubation-in-pediatric-trauma-a-descriptive-study
#7
T Simons, T Söderlund, L Handolin
PURPOSE: Pediatric prehospital endotracheal intubation (PHETI) is a difficult and rarely performed procedure that remains the gold standard for prehospital airway management when ventilation and/or anesthesia is required, but high complications rates, including malposition continue to concern. We reviewed the experience in our institution of pediatric intubations with particular emphasis on the position of the endotracheal tube (ETT) tip within the trachea and related complications. METHOD: Intubated pediatric patients presenting directly from the scene to our level 1 trauma center, between 2006 and 2014, were included in our study...
January 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28109108/-brachiocephalic-artery-sparing-aortic-arch-repair-combined-with-stent-graft-elephant-trunk-technique-for-stanford-type-a-aortic-dissection-analysis-of-23-cases
#8
Song-Lin DU, Jun Wan, Wu-Jun Wang, Kai-Can Cai, Ya-Xiang Liu, Xiang-Hui Mao
OBJECTIVE: To assess the clinical outcomes of brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique for treatment of Stanford type A aortic dissection. METHODS: Twenty-three patients with Stanford type A aortic dissection requiring arch replacement underwent brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique. The operations were performed within 72 h (20 cases) or 3-14 days (3 cases) after the onset of aortic dissection...
January 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28108578/the-activated-clotting-time-in-cardiac-surgery-should-celite-or-kaolin-be-used
#9
Adrianus J De Vries, Annemieke Oude Lansink-Hartgring, Freek-Jan Fernhout, Rolf C G Huet, Edwin R van den Heuvel
OBJECTIVES: Both kaolin- and Celite-activated clotting times (ACT) are used to guide anticoagulation during cardiopulmonary bypass. It is unknown whether these methods lead to similar management procedures for anticoagulation in patients and are thus interchangeable in terms of bias, precision and variability. METHODS: We randomized 97 patients undergoing coronary artery bypass grafting or aortic valve replacement to either kaolin- or Celite-guided anticoagulation...
January 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28066667/preoperative-computed-tomography-guided-dye-injection-to-localize-multiple-lung-nodules-for-video-assisted-thoracoscopic-surgery
#10
Yao-Hui Tseng, Yee-Fan Lee, Min-Shu Hsieh, Ning Chien, Wei-Chun Ko, Jo-Yu Chen, Jang-Ming Lee, Pei-Ming Huang, Mong-Wei Lin, Jin-Shing Chen, Yeun-Chung Chang
BACKGROUND: Preoperative computed tomography (CT)-guided localization of small lung nodules is important for accurate and efficient video-assisted thoracoscopic surgery (VATS). Resection of multiple small pulmonary nodules in one VATS procedure can aid in patient management. The aim of this study was to evaluate the usefulness of CT-guided Patent Blue V (PBV) dye localization in patients with multiple pulmonary nodules who underwent VATS. METHODS: This retrospective study was conducted from January 2013 to December 2015...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28057296/routine-post-operative-esophagram-is-not-necessary-after-repair-of-esophageal-atresia
#11
Jamie Golden, Natalie E Demeter, Joanna C Lim, Henri R Ford, Jeffrey S Upperman, Christopher P Gayer
INTRODUCTION: Esophagrams are routinely performed following repair of esophageal atresia (EA) with or without tracheoesophageal fistula (TEF); however, its utility has not been validated. METHODS: EA/TEF repair performed from 2003 to 2014 at a single pediatric hospital and from 2004 to 2014 in the Pediatric Health Information System (PHIS) database were retrospectively reviewed to determine utility of esophagrams. RESULTS: Esophagram was performed in 99% of patients at our institution (N = 105)...
December 30, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28049376/management-of-pleural-space-after-lung-resection-by-cryoneuroablation-of-phrenic-nerve
#12
Xiao-Jie Pan, De-Bin Ou, Xing Lin, Ming-Fang Ye
OBJECTIVES: Residual air space problems after pulmonary lobectomy are an important concern in thoracic surgical practice, and various procedures have been applied to manage them. This study describes a novel technique using controllable paralysis of the diaphragm by localized freezing of the phrenic nerve, and assesses the effectiveness of this procedure to reduce air space after pulmonary lobectomy. METHODS: In this prospective randomized study, 207 patients who underwent lobectomy or bilobectomy and systematic mediastinal node dissection in our department between January 2009 and November 2013 were randomly allocated to a cryoneuroablation group or a conventional group...
January 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28040756/current-practices-in-the-management-of-malignant-pleural-effusions-a-survey-among-members-of-the-european-society-of-thoracic-surgeons
#13
Marco Scarci, Edward Caruana, Luca Bertolaccini, Benedetta Bedetti, Alessandro Brunelli, Gonzalo Varela, Kostas Papagiannopoulos, Jaroslaw Kuzdzal, Gilbert Massard, Enrico Ruffini, Pierre Emmanuel Falcoz, Isabelle Opitz, Hasan Batirel, Alper Toker, Gaetano Rocco
OBJECTIVES: Malignant pleural effusion (MPE) commonly complicates advanced malignancy and their exact management is still undefined. We undertook a survey to determine the current practice among members of the European Society of Thoracic Surgeons (ESTS). METHODS: A cross-sectional survey focused on the current practice of management of MPE was developed by the authors. The questions were outlined after a review of the literature and circulated in an Internet-based survey format...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28018766/differentiation-of-lung-cancer-empyema-and-abscess-through-the-investigation-of-a-dry-cough
#14
Brittany Urso, Scott Michaels
An acute dry cough results commonly from bronchitis or pneumonia. When a patient presents with signs of infection, respiratory crackles, and a positive chest radiograph, the diagnosis of pneumonia is more common. Antibiotic failure in a patient being treated for community-acquired pneumonia requires further investigation through chest computed tomography. If a lung mass is found on chest computed tomography, lung empyema, abscess, and cancer need to be included on the differential and managed aggressively. This report describes a 55-year-old Caucasian male, with a history of obesity, recovered alcoholism, hypercholesterolemia, and hypertension, presenting with an acute dry cough in the primary care setting...
November 24, 2016: Curēus
https://www.readbyqxmd.com/read/28012691/multicentre-survey-on-the-current-surgical-management-of-oesophageal-atresia-in-belgium-and-luxembourg
#15
Helena Reusens, Lucas Matthyssens, Charlotte Vercauteren, Katrien van Renterghem
INTRODUCTION: The surgical management of oesophageal atresia (OA) differs between pediatric surgical teams without consensus. We aimed to describe the current practice of OA treatment in Belgium and Luxembourg and compare this to the literature. MATERIALS AND METHODS: A questionnaire was created and sent to all 18 hospitals (14 pediatric surgical units) performing OA surgery in Belgium and Luxembourg. The results were compared to the literature. RESULTS: Most units treat an average of 2-5 OA+TOF (71%) and ≤1 pure OA (pOA) per year (86%)...
February 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27994448/clinical-and-radiological-outcome-following-pneumothorax-after-endoscopic-lung-volume-reduction-with-valves
#16
D Gompelmann, N Benjamin, K Kontogianni, Fjf Herth, C P Heussel, H Hoffmann, R Eberhardt
INTRODUCTION: Valve implantation has evolved as a therapy for patients with advanced emphysema. Although it is a minimally invasive treatment, it is associated with complications, the most common being pneumothorax. Pneumothorax occurs due to the rapid target lobe volume reduction and may be a predictor of clinical benefit despite this complication. OBJECTIVE: The objective of this study was to conduct an exploratory data analysis of patients who developed a pneumothorax following endoscopic valve therapy for emphysema...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27984384/mixing-it-up-coadministration-of-tpa-dnase-in-complicated-parapneumonic-pleural-effusions-and-empyema
#17
Raju Bishwakarma, Shiwan Shah, Luba Frank, Wei Zhang, Gulshan Sharma, Shawn P E Nishi
BACKGROUND: A recent randomized controlled trial showed 12 serial doses of tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) is safe and effective in managing complicated parapneumonic pleural effusions and empyema (CPEE). However, this regimen is laborious, requiring trained personnel to open/close the chest tube 8 times daily for 3 days. We present our observational data using a simplified regimen of coadministered tPA/DNase. MATERIALS AND METHODS: This is a retrospective observational study of patients who received coadministered tPA/DNase for CPEE from January 2012 to April 2015 at the University of Texas Medical Branch...
January 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/27980753/noninvasive-management-for-iatrogenic-splenic-injury-caused-by-chest-tube-insertion-a-case-report
#18
Kazuto Ohtaka, Ryunosuke Hase, Ryohei Chiba, Mamoru Miyasaka, Shoki Sato, Yasuhito Shoji, Tatsunosuke Ichimura, Naoto Senmaru, Kichizo Kaga, Yoshiro Matsui
Splenic injury is one of the most critical complications of chest tube insertion and often requires invasive emergency management. However, noninvasive management such as delayed removal of the malpositioned tube may be considered for a stable patient without severe adverse event.
December 2016: Clinical Case Reports
https://www.readbyqxmd.com/read/27939204/role-of-glycopyrrolate-in-healing-of-anastomotic-dehiscence-after-primary-repair-of-esophageal-atresia-in-a-low-resource-setting-a-randomized-controlled-study
#19
Mahesh Manilal Vaghela, J K Mahajan, Jegadeesh Sundram, Neerja Bhardwaj, K L N Rao
AIMS: To investigate the role of glycopyrrolate in decreasing oral secretions in patients of esophageal atresia (EA) with anastomotic leak and evaluate its effect on healing of anastomotic dehiscence. METHODS: The study comprised consecutive neonates of esophageal atresia, who had undergone primary surgery and developed anastomotic leak. The patients were randomized into two groups with the observer blinded to the group. The patients in the treatment group were administered glycopyrrolate in the dose of 8 μg/kg 8 hourly, whereas placebo group patients were injected normal saline only...
November 23, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27900328/blunt-traumatic-tension-chylothorax-case-report-and-mini-review-of-the-literature
#20
Kamal Idris, Michael Sebastian, Ashraf F Hefny, Navidul Haq Khan, Fikri M Abu-Zidan
Tension chylothorax following blunt thoracic trauma is an extremely rare condition. Here we report such a case and review its management. A 31-year-old man was involved in a road traffic collision. The car rolled over and the patient was ejected from the vehicle. On arrival at the Emergency Department the patient was conscious and haemodynamically stable. Clinical examination of the chest and abdomen was normal. The patient had sustained fractures of the sixth cervical vertebra and the tenth thoracic vertebra, left pleural effusion, haematoma around the descending aorta and fracture of the right clavicle...
November 16, 2016: World Journal of Clinical Cases
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