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pleural drainage systems

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https://www.readbyqxmd.com/read/28215134/drainage-of-pleural-effusion-improves-diaphragmatic-function-in-mechanically-ventilated-patients
#1
Michele Umbrello, Giovanni Mistraletti, Andrea Galimberti, Ilaria R Piva, Ottavia Cozzi, Paolo Formenti
BACKGROUND: Pleural effusion adversely affects the pressuregenerating capacity of the diaphragm. It uncouples the lung and chest wall, which may result in diaphragmatic dysfunction. Information on the effects of effusion drainage on diaphragmatic function is limited, but several studies report relief of dyspnoea after drainage, which was attributed to improved diaphragmatic mechanics, even if this issue was never formally addressed. OBJECTIVE: To investigate the effect of drainage of unilateral pleural effusion on diaphragmatic function...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28193088/scrotal-abscess-a-rare-presentation-of-complicated-necrotizing-pancreatitis
#2
Seyyedhadi Mirhashemi, Mohsen Soori, Gholamhossein Faghih, Hassan Peyvandi, Omid Shafagh
Acute pancreatitis is characterized by activation of digestive enzymes inside the pancreas. In severe pancreatitis, necrosis of pancreas and surrounding tissues may occur. Acute necrotizing pancreatitis commonly presents as pancreatic abscess occasionally with systemic complications. Rarely, necrotic tissue may be drained from scrotum due to retroperitoneal extension of necrotic process. Here, we report a case of acute necrotizing pancreatitis in a 29-year-old man who presented with severe abdominal pain, nausea and vomiting...
February 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28156621/comparison-of-two-indwelling-pleural-catheter-types-for-malignant-pleural-effusions
#3
Sushilkumar Satish Gupta, Abhinav Binod Chandra
: 205 Background: Indwelling pleural catheter (IPC) placement is an alternative to chemical pleurodesis for malignant pleural effusion (MPE), a complication of advanced cancer. In 1997 an IPC was approved which uses vacuum bottles (VB) for drainage (PleurX, Becton, Dickinson and Company, Franklin Lakes, NJ), and later another IPC system, which employs a manually operated vacuum pump (VP) for drainage (Aspira, Bard Access Systems, Salt Lake City, UT). Most studies comparing IPC versus chemical pleurodesis used the VB IPC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28131104/a-simplified-technique-for-drainage-of-chronic-calcified-pleural-empyema
#4
Sani Rabiou, Hama Younssa, James Didier, Magagi Ibrahim, Adamou Harissou, Ousseini Adakal, Rachid Sani
Chronic pleural pocket has well-known diagnosis and treatment principles since first described by Hippocrates 2,400 years ago. However, its treatment remains constant even though its causes, severity during management, and terrain vary considerably. In well-structured health care systems, posttuberculous empyema has become rare; its well-codified medical treatment relies on early diagnosis and adapted antibiotherapy, punctures/drainage, and appropriate intrapleural antifibrinolytics. In developing countries, a poor health organizational system increases the incidence of pleural pocket, which can progress until surgery is indicated...
January 28, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28104132/everolimus-induced-systemic-serositis-after-simultaneous-liver-and-kidney-transplantation-a-case-report
#5
K Kim, D W Jeong, Y H Lee, Y G Kim, J-Y Moon, K-H Jeong, T W Lee, C-G Ihm, S-H Joo, H-C Park, S-H Lee
Although everolimus, a mammalian target of rapamycin inhibitor, has been used as a potent immunosuppressive agent in organ transplantation, data regarding its adverse effect profile compared with that of sirolimus in clinical circumstances are limited. A 50-year-old man who underwent simultaneous liver and kidney transplantation 14 months previously was admitted with large pleural effusion, pericardial effusion, and ascites. Laboratory findings and cultures for possible infectious causes were all negative. Pericardial window surgery with drainage of the pericardial fluid was performed on day 3...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28087049/-the-benefits-of-digital-chest-drainage-in-pleural-decortication-in-thoracic-empyema-prospective-randomized-control-trial
#6
José M Mier, Gildardo Cortés-Julián, Juan Berrios-Mejía, Zotés Víctor-Valdivia
BACKGROUND: Prolonged air leak after pleural decortication is one of the most frequent complications. OBJECTIVE: The aim of this study is to compare the effects of prolonged air leak between the digital chest drainage (DCD) system and the classic drainage system in patients with empyema class IIB or III (American Thoracic Society classification) in pleural decortication patients. MATERIAL AND METHODS: A total of 37 patients were enrolled in a prospective randomized control trial over one year, consisting of 2blinded groups, comparing prolonged air leak as a main outcome, the number of days until removal of chest drain, length of hospital stay and complications as secondary outcomes...
January 10, 2017: Cirugia y Cirujanos
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
#7
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/27904839/noncardiac-thoracic-surgery-in-abidjan-from-1977-to-2015
#8
Yves Tanauh, Flavien Kendja, Hervé Yangni-Angate, Blaise Demine, Raphaël Ouédé, Maurice Kouacou
BACKGROUND: To report and analyze noncardiac thoracic operations performed at the Cardiology Institute of Abidjan (Institut de Cardiologie d'Abidjan) from 1977 to 2015. METHODS: This is a retrospective and descriptive study covering 39 years, from 1977 to 2015. This study period was divided into three periods of 13 years each: P1 from 1977 to 1989, P2 from 1990 to 2002 and P3 from 2003 to 2015. Medical records of 2014 operated patients were analyzed: 414 patients for P1, 464 patients for P2, 1,136 patients for P3...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27891283/streptococcus-intermedius-causing-necrotizing-pneumonia-in-an-immune-competent-female-a-case-report-and-literature-review
#9
Faris Hannoodi, Israa Ali, Hussam Sabbagh, Sarwan Kumar
We report a case of a 52-year-old immunocompetent Caucasian female treated for necrotizing Streptococcus intermedius pneumonia and review available literature of similar cases. Our patient presented with respiratory failure and required hospitalization and treatment in the intensive care unit. Moreover, she required surgical drainage of right lung empyema as well as decortication and resection. The review of literature revealed three cases of S. intermedius pneumonia, one of which was a mortality. Comparison of the published cases showed a highly varied prehospital course and radiological presentations, with a symptomatic phase ranging from 10 days to five months...
2016: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/27865322/thoracic-trauma-which-chest-tube-when-and-where
#10
REVIEW
Tamas F Molnar
Clinical suspicion of hemo/pneumothorax: when in doubt, drain the chest. Stable chest trauma with hemo/pneumothorax: drain and wait. Unstable patient with dislocated trachea must be approached with drain in hand and scalpel ready. Massive hemo/pneumothorax may be controlled by drainage alone. The surgeon should not hesitate to open the chest if too much blood drains over a short period. The chest drainage procedure does not end with the last stitch; the second half of the match is still ahead. The drained patient is in need of physiotherapy and proper pain relief with an extended pleural space: control the suction system...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27852713/effects-of-increased-positive-end-expiratory-pressure-on-intracranial-pressure-in-acute-respiratory-distress-syndrome-a-protocol-of-a-prospective-physiological-study
#11
Han Chen, Ming Xu, Yan-Lin Yang, Kai Chen, Jing-Qing Xu, Ying-Rui Zhang, Rong-Guo Yu, Jian-Xin Zhou
INTRODUCTION: There are concerns that the use of positive end-expiratory pressure (PEEP) in patients with brain injury may potentially elevate intracranial pressure (ICP). However, the transmission of PEEP into the thoracic cavity depends on the properties of the lungs and the chest wall. When chest wall elastance is high, PEEP can significantly increase pleural pressure. In the present study, we investigate the different effects of PEEP on the pleural pressure and ICP in different respiratory mechanics...
November 15, 2016: BMJ Open
https://www.readbyqxmd.com/read/27709281/stratifying-fibrinolytic-dosing-in-pediatric-parapneumonic-effusion-based-on-ultrasound-grade-correlation
#12
Charles A James, Leah E Braswell, Amir H Pezeshkmehr, Paula K Roberson, James A Parks, Mary B Moore
BACKGROUND: Complicated pleural effusion prolongs the hospital course of pneumonia. Chest tube placement with instillation of fibrinolytic medication allows efficient drain output and decreases hospital stay. OBJECTIVE: To evaluate experience with lower fibrinolytic dose for parapneumonic effusions and to assess potential dose stratification based on a simple ultrasound grading system. MATERIALS AND METHODS: We retrospectively reviewed the medical record to identify children and young adults who received fibrinolytic therapy for parapneumonic effusion and had chest tube placement by an interventional radiology service at a single children's hospital...
January 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/27687259/spontaneous-pneumothorax-in-paracoccidioidomycosis-patients-from-an-endemic-area-in-midwestern-brazil
#13
Lucas G G Cabrera, Aline F Santos, Ursulla V Andrade, Carlos Ivan A Guedes, Sandra M V L Oliveira, Marilene R Chang, Rinaldo P Mendes, Anamaria M M Paniago
Paracoccidioidomycosis (PCM) is the most important systemic mycosis in Latin America. About 80% of PCM patients are present with its chronic form. The lungs are affected in most patients with the chronic form; however, pleural involvement has rarely been reported. We describe nine cases of PCM that presented with lung involvement and spontaneous pneumothorax. All patients, except one whose condition was not investigated, were smokers. PCM was diagnosed during the pneumothorax episode in three patients, and from 3 to 16 years before the pneumothorax episode in six patients...
September 30, 2016: Mycoses
https://www.readbyqxmd.com/read/27648553/therapy-of-645-children-with-parapneumonic-effusion-and-empyema-a-german-nationwide-surveillance-study
#14
Florian J Segerer, Karin Seeger, Anna Maier, Christine Hagemann, Christoph Schoen, Mark van der Linden, Andrea Streng, Markus A Rose, Johannes G Liese
OBJECTIVE: To evaluate the initial management of pediatric parapneumonic effusion or pleural empyema (PPE/PE) with regard to length of hospital stay (LOS). METHODS: Collection of pediatric PPE/PE cases using a nationwide surveillance system (ESPED) from 10/2010 to 06/2013, in all German pediatric hospitals. Inclusion of PPE/PE patients <18 years of age requiring drainage or with a PPE/PE persistence >7 days. Staging of PPE/PE based on reported pleural sonographic imaging...
September 20, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27460398/intrapleural-urokinase-therapy-in-a-neonate-with-pleural-empyema
#15
Lily Myung-Jin Cha, Sunha Choi, Taehwan Kim, Shin Won Yoon
Pleural empyema is rare in neonates, and treatment with systemic antibiotics and tube drainage may fail because of the thick viscous fluid, bacterial products with fibrin deposition, and multiple loculations. Intrapleural fibrinolytic therapy with urokinase is an effective and non-invasive treatment option that avoids surgical intervention, although its use in neonates has not been studied extensively. In this report, we describe the case of a 13-day-old male neonate with Escherichia coli sepsis and pneumonia, which rapidly progressed to parapneumonic effusion and pleural empyema...
July 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27355740/watertight-sealing-without-lumbar-drainage-for-incidental-ventral-dural-defect-in-transthoracic-spine-surgery-a-retrospective-review-of-53-cases
#16
Sang-Hyeop Jeon, Sang-Ho Lee, Yi Sheng Tsang, Tag-Geun Jung, Ki-Hyoung Moon, Gun Choi, Ketan Deshpande
STUDY DESIGN: A retrospective review. OBJECTIVES: To evaluate the therapeutic efficacy of the triple layer closure technique to establish watertight sealing without diversion of lumbar drainage, in preventing persistent incidental subarachnoid-pleural fistula and other neurologic complications related to excessive drainage of cerebrospinal fluid (CSF) after dural defect in transthoracic ossified posterior longitudinal ligament (OPLL) surgery. SUMMARY OF BACKGROUND DATA: Cerebrospinal fluid (CSF) leakage into the pleural cavity leads to unfavorable conditions for natural healing of incidental durotomy due to the negative pressure environment of the pleural space and lack of wound healing around the bony cavity near the decompressed spinal cord...
June 28, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27234573/digital-drainage-system-reduces-hospitalization-after-video-assisted-thoracoscopic-surgery-lung-resection
#17
Daniel L Miller, Gerald A Helms, William R Mayfield
BACKGROUND: The purpose of this study was to assess the efficacy of a digital versus traditional drainage system on hospitalization for patients undergoing video-assisted thoracoscopic surgery (VATS) anatomic lung resection. METHODS: Consecutive patients who underwent VATS anatomic lung resection (July 2014 through January 2015) for lung cancer were analyzed. Patients were managed with overnight suction (-20 cm H2O) followed by gravity drainage (water seal or -8 cm H2O) in both the traditional and digital drainage systems, respectively; the digital system also allowed for continuous monitoring of air leaks...
September 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27055073/phenotyping-malignant-pleural-effusions
#18
Macy M S Lui, Deirdre B Fitzgerald, Y C Gary Lee
PURPOSE OF REVIEW: Patients with malignant pleural effusions (MPEs) are heterogenous in their disease course, symptom severity, responses to cancer therapies, fluid recurrence rates, and thus need for definitive fluid control measures. To tailor the most appropriate treatment for individual patients, clinicians need to 'phenotype' the patients and predict their clinical course. This review highlights the recent efforts to develop better predictive tools and knowledge gaps for further research...
July 2016: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/27048219/management-of-chest-drainage-tubes-after-lung-surgery
#19
REVIEW
Yukitoshi Satoh
Since chest tubes have been routinely used to drain the pleural space, particularly after lung surgery, the management of chest tubes is considered to be essential for the thoracic surgeon. The pleural drainage system requires effective drainage, suction, and water-sealing. Another key point of chest tube management is that a water seal is considered to be superior to suction for most air leaks. Nowadays, the most common pleural drainage device attached to the chest tube is the three-bottle system. An electronic chest drainage system has been developed that is effective in standardizing the postoperative management of chest tubes...
June 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27043191/pleural-gas-analysis-for-the-identification-of-alveolopleural-fistulae
#20
Ramiro Fernandez, Ankit Bharat
PURPOSE OF REVIEW: The method for identification of alveolopleural fistulae (APF) by visual inspection of air bubbles in the chest drainage system has several limitations and suffers from poor accuracy. Here we discuss the use of a novel technique of pleural gas analysis in the identification and management of APF. RECENT FINDINGS: We found that pleural gas analysis has higher sensitivity and specificity than visual inspection in identifying APF. Additionally, we demonstrated that intrapleural gas milieu impacts lung healing and reduction of intrapleural carbon dioxide can promote resolution of APF...
July 2016: Current Opinion in Pulmonary Medicine
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