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Tunneled Pleural catheter

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https://www.readbyqxmd.com/read/29346248/the-utility-of-ultrasound-to-diagnose-tunnel-tract-infection-related-to-indwelling-pleural-catheters
#1
Jose Cardenas-Garcia, Neal Fitzpatrick, George Z Cheng
Indwelling pleural catheter (IPC) infections lead to increased morbidity and treatment failure in patients with chronic recurrent pleural effusions. Ultrasonography is a readily available diagnostic tool used by pulmonologists on a daily basis. Ultrasonography has been used to identify the etiology of indwelling peritoneal catheter obstruction, including infection of the exit site and tunnel tract. The use of ultrasonography to identify tunnel-tract infection involving IPC has not been reported. We describe the ultrasonographic characteristics of 3 cases of confirmed tunnel-tract infection and compared them with noninfected chronic IPCs...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29311408/hepatic-hydrothorax
#2
Yong Lv, Guohong Han, Daiming Fan
Hepatic hydrothorax (HH) is a pleural effusion that develops in a patient with cirrhosis and portal hypertension in the absence of cardiopulmonary disease. Although the development of HH remains incompletely understood, the most acceptable explanation is that the pleural effusion is a result of a direct passage of ascitic fluid into the pleural cavity through a defect in the diaphragm due to the raised abdominal pressure and the negative pressure within the pleural space. Patients with HH can be asymptomatic or present with pulmonary symptoms such as shortness of breath, cough, hypoxemia, or respiratory failure associated with large pleural effusions...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29288227/endobronchial-metastasis-of-mixed-mullerian-tumour-of-the-uterus
#3
Vadsala Baskaran, Laura Pugh, Robert James Berg, John Anderson
Endobronchial metastasis occurs in only 2%-5% of non-pulmonary cancers. Here we report on an 84-year-old woman who presented with breathlessness and light-headedness while on holiday in Australia, 2 years post-treatment for endometrial cancer. Initial CT pulmonary angiogram identified a soft tissue mass in the left hemithorax. A chest radiograph performed after repatriation was consistent with a large left pleural effusion, but bedside ultrasound showed a lobulated mass involving the left hemidiaphragm. A pleural procedure in the traditional 'triangle of safety' would have resulted in inadvertent puncture of the underlying mass...
December 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29249857/symptomatic-fluid-drainage-tunneled-peritoneal-and-pleural-catheters
#4
REVIEW
Tony Ha, David C Madoff, David Li
Malignant ascites and pleural effusion are significant contributors to patient symptoms such as shortness of breath, abdominal distension, and nausea in the setting of cancer. There are numerous methods employed to control such symptoms such as serial drainages, pleurodesis, and tunneled drainage catheters. Tunneled drainage catheters are a safe, effective, and a minimally invasive procedure to palliate the symptoms of malignant ascites and pleural effusion.
December 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29214061/medical-thoracoscopy-and-its-evolving-role-in-the-diagnosis-and-treatment-of-pleural-disease
#5
REVIEW
Vivek Murthy, Jamie L Bessich
Establishing the etiology of exudative pleural effusions in the setting of an unrevealing pleural fluid analysis often requires biopsies from the parietal pleura. While closed pleural biopsy (CPB) has been a popular minimally-invasive approach, it has a poor diagnostic yield, barring a diagnosis of tuberculous pleurisy. Medical thoracoscopy (MT) is a minimally-invasive ambulatory procedure performed under local anesthesia or moderate sedation which allows for direct visualization of biopsy targets as well as simultaneous therapeutic interventions, including chemical pleurodesis and indwelling tunneled pleural catheter (ITPC) placement...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29188375/tunneled-pleural-catheter-use-for-pleural-palliation-does-not-increase-infection-rate-in-patients-with-treatment-related-immunosuppression
#6
Candice L Wilshire, Christopher R Gilbert, Brian E Louie, Ralph W Aye, Alexander S Farivar, Eric Vallières, Jed A Gorden
PURPOSE: Concerns for infections resulting from antineoplastic therapy-associated immunosuppression may deter referral for symptom palliation with a tunneled pleural catheter (TPC) in patients with malignant/para-malignant pleural effusions (MPE/PMPE). While rates of TPC-related infections range from 1 to 21%, those in patients receiving antineoplastic therapy with correlation to immune status has not been established. We aimed to assess TPC-related infection rates in patients on antineoplastic therapy, determine relation to immune system competency, and assess impact on the patient...
November 29, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28918827/indwelling-pleural-catheters-for-nonmalignant-effusions-evidence-based-answers-to-clinical-concerns
#7
REVIEW
David Maurice Chambers, Bilal Abaid, Umair Gauhar
Pleural effusions occur in 1.5 million patients yearly and are a common cause of dyspnea. For nonmalignant effusions, initial treatment is directed at the underlying cause, but when effusions become refractory to medical therapy, palliative options are limited. Tunneled pleural catheters (TPCs) are commonly used for palliation of malignant effusions, but many clinicians are reluctant to recommend these devices for palliation of nonmalignant effusions, citing concerns of infection, renal failure, electrolyte disturbances and protein-loss malnutrition...
September 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28851719/surgical-and-catheter-based-reinterventions-are-common-in-long-term-survivors-of-the-fontan-operation
#8
Tacy E Downing, Kiona Y Allen, David J Goldberg, Lindsay S Rogers, Chitra Ravishankar, Jack Rychik, Stephanie Fuller, Lisa M Montenegro, James M Steven, Matthew J Gillespie, Jonathan J Rome, Thomas L Spray, Susan C Nicolson, J William Gaynor, Andrew C Glatz
BACKGROUND: There are limited follow-up studies examining surgical and catheter-based reinterventions in long-term survivors of the Fontan operation. METHODS AND RESULTS: All 773 patients who underwent Fontan at our institution between 1992 and 2009 were retrospectively reviewed. Current information regarding post-Fontan intervention was available for 70%. By 20 years after Fontan, 65% of patients had experienced either surgical or transcatheter intervention. The median time to first reintervention was 9...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28799457/a-single-institution-experience-for-the-management-of-recurrent-pleural-effusions-with-tunneled-pleural-catheter-and-its-evolution
#9
Tuhina Raman, Nikhil Meena
BACKGROUND: Indwelling tunneled pleural catheters (TPCs) are increasingly being used to treat recurrent pleural effusions. There is also an increased interest in early pleurodesis in order to prevent infectious complications. We studied the time to removal and other outcomes for all the TPCs placed at our institution. METHODS: After institutional review board approval, records of patients who had had a TPC placed between July 2009 and June 2016 were reviewed; the catheters were placed in an endoscopy suite or during pleuroscopy with or without a sclerosant...
September 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28426468/indwelling-tunneled-pleural-catheters-for-the-management-of-hepatic-hydrothorax
#10
Kevin P Haas, Alexander C Chen
PURPOSE OF REVIEW: Hepatic hydrothorax is a complication of end-stage liver disease that may have significant associated morbidity. Sodium restriction and diuretic therapy are the mainstays of treatment, though up to a quarter of patients will become refractory to this and will require a pleural drainage procedure. Thoracentesis, transjugular intrahepatic portosystemic shunt, and chemical pleurodesis all have variable success rates and associated complications in the management of hepatic hydrothorax...
July 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28409687/the-evolving-role-of-the-indwelling-tunneled-pleural-catheter-a-means-to-an-end
#11
A Christine Argento, Frank Schembri
No abstract text is available yet for this article.
April 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28069787/bilateral-indwelling-pleural-catheter-for-hepatic-hydrothorax
#12
Rossella D'Amato, Luisa E Eiroa González, Ana Isabel Hernández Méndez
A 68-year-old man with alcoholic liver cirrhosis and portal hypertension was admitted due to ascites. Bilateral severe hepatic hydrothorax did not resolve despite sodium restriction, and diuretic treatment, requiring repeated thoracentesis for relief of dyspnoea. Curative options, as transjugular intrahepatic portosystemic shunt and liver transplantation were both contraindicated. An attempt of pleurodesis was ineffective. Bilateral insertion of tunnelled pleural catheter allowed symptom control and home discharge...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28058594/an-algorithm-for-management-after-transjugular-intrahepatic-portosystemic-shunt-placement-according-to-clinical-manifestations
#13
REVIEW
Seung Kwon Kim, Bryan G Belikoff, Carlos J Guevara, Seong Jin Park
We propose an algorithm for management after transjugular intrahepatic portosystemic shunt (TIPS) placement according to clinical manifestations. For patients with an initial good clinical response, surveillance Doppler ultrasound is recommended to detect stenosis or occlusion. A TIPS revision can be performed using basic or advanced techniques to treat stenosis or occlusion. In patients with an initial poor clinical response, a TIPS venogram with pressure measurements should be performed to assess shunt patency...
February 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27898215/randomized-trial-of-pleural-fluid-drainage-frequency-in-patients-with-malignant-pleural-effusions-the-asap-trial
#14
RANDOMIZED CONTROLLED TRIAL
Momen M Wahidi, Chakravarthy Reddy, Lonny Yarmus, David Feller-Kopman, Ali Musani, R Wesley Shepherd, Hans Lee, Rabih Bechara, Carla Lamb, Scott Shofer, Kamran Mahmood, Gaetane Michaud, Jonathan Puchalski, Samaan Rafeq, Stephen M Cattaneo, John Mullon, Steven Leh, Martin Mayse, Samantha M Thomas, Bercedis Peterson, Richard W Light
RATIONALE: Patients with malignant pleural effusions have significant dyspnea and shortened life expectancy. Indwelling pleural catheters allow patients to drain pleural fluid at home and can lead to autopleurodesis. The optimal drainage frequency to achieve autopleurodesis and freedom from catheter has not been determined. OBJECTIVES: To determine whether an aggressive daily drainage strategy is superior to the current standard every other day drainage of pleural fluid in achieving autopleurodesis...
April 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27870682/advances-in-interventional-oncology-lung-cancer
#15
REVIEW
Philip J Dempsey, Carole A Ridge, Stephen B Solomon
Image-guided lung intervention in the oncologic patient includes transthoracic needle biopsy, thermal ablation, fiducial placement, and tunneled pleural catheter placement and is made possible by technical advancements in computed tomography, fluoroscopy, and ultrasound technology, as well as the proliferation of available thermal ablation modalities such as radiofrequency, microwave, and cryoablation. With increasingly earlier cancer diagnoses being made and a greater patient demand for minimally invasive therapies, interventional oncology has many options to offer the patient with thoracic malignancies...
November 2016: Cancer Journal
https://www.readbyqxmd.com/read/27747006/patient-evaluation-for-rapid-pleurodesis-of-malignant-pleural-effusions
#16
Rebecca Krochmal, Chakravarthy Reddy, Lonny Yarmus, Neeraj R Desai, David Feller-Kopman, Hans J Lee
BACKGROUND: Malignant pleural effusions (MPEs) represent advanced stage disease with potentially significant patient discomfort due to dyspnea. Palliative management options include repetitive thoracenteses, placement of a tunneled pleural catheter (TPC), chemical pleurodesis, or some combination of these procedures. The rapid pleurodesis procedure combines thoracoscopic talc pleurodesis and insertion of a TPC at the same time with the goals of reducing both the length of hospitalization and the duration of catheter use...
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27509162/indwelling-tunneled-pleural-catheters-for-the-management-of-hepatic-hydrothorax-a-word-of-caution
#17
Aibek E Mirrakhimov, Taha Ayach, Adam Gray
No abstract text is available yet for this article.
August 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27509161/reply-indwelling-tunneled-pleural-catheters-for-the-management-of-hepatic-hydrothorax-a-word-of-caution
#18
Alexander C Chen, Jeffrey S Crippin
No abstract text is available yet for this article.
August 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27368006/pleural-ldh-as-a-prognostic-marker-in-adenocarcinoma-lung-with-malignant-pleural-effusion
#19
Akash Verma, Chee Kiang Phua, Wen Yuan Sim, Reyes Elmer Algoso, Kuan Sen Tee, Sennen J W Lew, Albert Y H Lim, Soon Keng Goh, Dessmon Y H Tai, Ai Ching Kor, Benjamin Ho, John Abisheganaden
To study the performance of serum and pleural lactate dehydrogenase (LDH) level in predicting survival in patients with adenocarcinoma lung presenting with malignant pleural effusions (MPE) at initial diagnosis.Retrospective cohort study of the patient hospitalized for adenocarcinoma lung with MPE in year 2012.Univariate analyses showed lower pleural fluid LDH 667 (313-967) versus 971 (214-3800), P = 0.04, female gender 9 (100%) versus 27 (41.5%), P = 0.009, never smoking status 9 (100%) versus 36 (55.3%), P = 0...
June 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27243620/tunneled-indwelling-pleural-catheters-for-refractory-pleural-effusions-after-solid-organ-transplant-a-case-control-study
#20
Joseph H Skalski, Jasleen Pannu, Humberto C Sasieta, Eric S Edell, Fabien Maldonado
RATIONALE: The use of tunneled indwelling pleural catheters for management of refractory pleural effusions continues to increase. Pleural space infections are among the most common and serious complication of the procedure. The risk may be higher in patients receiving immunosuppressive medications. OBJECTIVES: The aim of this study was to assess the risk of infections complicating placement of a tunneled indwelling pleural catheter in patients who have received a solid organ transplant...
August 2016: Annals of the American Thoracic Society
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