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Chest tube management

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https://www.readbyqxmd.com/read/28916211/diaphragmatic-fenestration-for-refractory-chylothorax-after-congenital-cardiac-surgery-in-infants
#1
T K Susheel Kumar, Kaitlin Balduf, Umar Boston, Christopher Knott-Craig
OBJECTIVE: Medically refractory chylous pleural effusion after congenital heart surgery is associated with significant morbidity and mortality, especially in infants. We reviewed our experience with diaphragmatic fenestration procedure in this group of patients. METHODS: A retrospective chart review of all patients who had diaphragmatic fenestrations for chylous effusion at our institution over a 2-year period was performed. RESULTS: A total of 9 diaphragmatic fenestration procedures were performed in 8 patients who had failed medical management of chylous pleural effusions...
August 17, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28902086/operative-stabilization-of-flail-chest-injuries-reduces-mortality-to-that-of-stable-chest-wall-injuries
#2
Niloofar Dehghan, Jeffrey M Mah, Emil H Schemitsch, Aaron Nauth, Milena Vicente, Michael D McKee
OBJECTIVE: To determine the prevalence, management and outcomes of patients with flail chest injuries, compared to patients without flail chest injuries (single rib fractures and multiple rib fractures without a flail segment). DESIGN: Retrospective cohort study SETTING:: Ontario, Canada PARTICIPANTS:: Ontario residents over the age of 16 who had been admitted to hospital with a chest wall injury from 2004 to 2015 were identified using administrative health care databases...
August 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28879077/a-rare-case-of-actinomyces-meyeri-empyema-still-a-challenging-entity-to-manage
#3
Vera Clérigo, Lígia Fernandes, Amélia Feliciano, Lurdes Carvalho
Actinomyces meyeri is a rare pathogen and an infrequent cause of human actinomycosis. Less than ten cases were reported in the English-literature to date concerning A. meyeri empyema. We herein report a case to promote the awareness and adequate management of the disease. A 44-year-old immunocompetent male with known pulmonary disease was diagnosed with an A. meyeri empyema. He underwent chest tube drainage and a short-term treatment with clindamycin for 4 months. This is the first report of a patient with structural pulmonary disease with an A...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28870052/-clinical-efficacy-of-enhanced-recovery-after-surgery-in-atrial-caval-shunting-for-type-%C3%A2-budd-chiari-syndrome
#4
G J Tian, D Y Li, H B Yu, Y D Dong, Y N Peng, P Liu, Y K Wei, H Z Xue
Objective: To investigate the clinical efficacy of enhanced recovery after surgery(ERAS) in atrial caval shunting (ACS) for type Ⅱ Budd-Chiari syndrome(BCS). Methods: The clinical data of patients underwent ACS for type Ⅱ BCS in the Henan Province People's Hospital from January 2014 to June 2016 were prospectively analyzed.Randomized and single-blind, controlled study was performed among the patients, and all of them underwent ACS and were divided into control group (patients underwent traditional perioperative management) and ERAS group (patients underwent ERAS perioperative management) based on a random number table...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28864054/quality-gaps-and-comparative-effectiveness-of-management-strategies-for-recurrent-malignant-pleural-effusions
#5
David E Ost, Jiangong Niu, Hui Zhao, Horiana B Grosu, Sharon H Giordano
BACKGROUND: Guidelines for recurrent malignant pleural effusions (MPE) recommend definitive procedures, such as indwelling pleural catheters (IPC) or pleurodesis, over repeat thoracentesis. We hypothesized that many patients have multiple thoracenteses rather than definitive procedures and that this results in more procedures and complications. METHODS: Retrospective cohort study using SEER-Medicare data from 2007-2011. Patients age 66-90 with a MPE were included...
August 29, 2017: Chest
https://www.readbyqxmd.com/read/28840000/a-meta-analysis-of-video-assisted-thoracoscopic-decortication-versus-open-thoracotomy-decortication-for-patients-with-empyema
#6
Hui Pan, Jiaxi He, Jianfei Shen, Long Jiang, Wenhua Liang, Jianxing He
BACKGROUND: Thoracic pleural empyema is a collection of pus within a thoracic cavity. In stage 2 (fibrinopurulent) and stage 3 (organizational), decortication is the only choice. But there is no consensus on whether to choose video-assisted thoracoscopic decortication (VATD) or open thoracotomy decortication (OTD). We sought to answer this question by performing a meta-analysis. METHOD: Six electronic databases were searched. Primary outcomes were operative time, postoperative hospital stay, prolonged air leak, chest tube duration, relapse rate, morbidity and mortality...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28838021/-management-of-thoracic-trauma
#7
Bassam Redwan, Christian Biancosino, Katina Nikolova, Thorsten Greve, Servet Bölükbas
Patients with a thoracic trauma are commonly treated by large bore chest tube thoracostomy and appropriate analgesia. The initial treatment is determined by the assessment of the emergency doctor and/or trauma surgeon. Severe intrathoracic lesions in polytrauma patients are rare. However, such injuries may be acutely life-threating. After primary stabilisation of the patients, imaging studies should be performed to assess the extent of the injuries and determine the treatment of choice. Assessment of such injuries should always be performed in a multidisciplinary team of anaesthesiologists, general surgeons, trauma surgeons and thoracic surgeons...
August 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28837796/videothoracoscopic-surgery-before-and-after-chest-tube-drainage-for-children-with-complicated-parapneumonic-effusion
#8
Rogério Knebel, José Carlos Fraga, Sérgio Luis Amantéa, Paola Brolin Santis Isolan
OBJECTIVES: To evaluate the effectiveness of videothoracoscopic surgery (VATS) in the treatment of complicated parapneumonic pleural effusion (CPPE) and to determine whether there is a difference in the VATS outcome before or after the chest tube drainage. METHODS: The medical records of 79 children (mean age 35 months) undergoing VATS from January 2000 to December 2011 were retrospectively reviewed. The same treatment algorithm was used in the management of all patients...
August 21, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28814258/management-of-complicated-pneumonia-in-childhood-a-review-of-recent-literature
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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