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pleural drainage systems

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https://www.readbyqxmd.com/read/27904839/noncardiac-thoracic-surgery-in-abidjan-from-1977-to-2015
#1
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
#2
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
#3
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
#4
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
#5
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...
October 5, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27687259/spontaneous-pneumothorax-in-paracoccidioidomycosis-patients-from-an-endemic-area-in-midwestern-brazil
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27004393/-vasoplegic-syndrome-after-aortic-valve-replacement
#14
Kazuto Miyata, Sayaka Shigematsu
We report a case of vasoplegic syndrome (VS) after aortic valve replacement in a 65 year old male with aortic stenosis. The patient developed hypotension after separation from cardiopulmonary bypass (CPB). Transesophageal echocardiography revealed well-maintained cardiac function and normal prosthetic valve function. However, his cardiac index was 3.0 l x min(-1) x m(-2) and systemic vascular resistance index (SVRI) was 1100 dynes x sec(-1) x cm(-5) x m(-2). Diagnosing VS, norepinephrine administration was commenced...
January 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26998845/phase-iii-randomised-clinical-trial-comparing-primary-surgery-versus-neoadjuvant-chemotherapy-in-advanced-epithelial-ovarian-cancer-with-high-tumour-load-scorpion-trial-final-analysis-of-peri-operative-outcome
#15
Anna Fagotti, Gabriella Ferrandina, Giuseppe Vizzielli, Francesco Fanfani, Valerio Gallotta, Vito Chiantera, Barbara Costantini, Pasquale Alessandro Margariti, Salvatore Gueli Alletti, Francesco Cosentino, Lucia Tortorella, Giovanni Scambia
OBJECTIVE: To establishing whether neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is superior primary debulking surgery (PDS) in terms of clinical outcome as well as peri-operative morbidity in advanced epithelial ovarian cancer (AEOC) endowed with high tumour load (HTL). MATERIAL AND METHODS: This is a single-Institution, superiority, randomised phase III trial enrolling supposed AEOC women. Patients considered pre-operatively eligible were triaged to staging laparoscopy to assess the predictive index (PI) of tumour load...
May 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/26941971/advances-in-chest-drain-management-in-thoracic-disease
#16
REVIEW
Robert S George, Kostas Papagiannopoulos
An adequate chest drainage system aims to drain fluid and air and restore the negative pleural pressure facilitating lung expansion. In thoracic surgery the post-operative use of the conventional underwater seal chest drainage system fulfills these requirements, however they allow great variability amongst practices. In addition they do not offer accurate data and they are often inconvenient to both patients and hospital staff. This article aims to simplify the myths surrounding the management of chest drains following chest surgery, review current experience and explore the advantages of modern digital chest drain systems and address their disease-specific use...
February 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/26941970/air-leak-after-lung-resection-pathophysiology-and-patients-implications
#17
REVIEW
Cecilia Pompili, Giuseppe Miserocchi
Protocols for the management of air leaks are critical aspects in the postoperative course of patients following lung resections. Many investigations in the last decade are focusing on the chest tube modalities or preventative measures, however, little is known about the pathophysiology of air leak and the patient perception of this common complication. This review concentrates on understanding the reasons why a pulmonary parenchyma may start to leak or an air leak may be longer than others. Experimental works support the notion that lung overdistension may favor air leak...
February 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/26941968/optimizing-postoperative-care-protocols-in-thoracic-surgery-best-evidence-and-new-technology
#18
REVIEW
Daniel G French, Michael Dilena, Simon LaPlante, Farid Shamji, Sudhir Sundaresan, James Villeneuve, Andrew Seely, Donna Maziak, Sebastien Gilbert
Postoperative clinical pathways have been shown to improve postoperative care and decrease length of stay in hospital. In thoracic surgery there is a need to develop chest tube management pathways. This paper considers four aspects of chest tube management: (I) appraising the role of chest X-rays in the management of lung resection patients with chest drains; (II) selecting of a fluid output threshold below which chest tubes can be removed safely; (III) deciding whether suction should be applied to chest tubes; (IV) and selecting the safest method for chest tube removal...
February 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/26796806/-internal-mammary-sentinel-lymph-node-biopsy-in-breast-cancer-accurate-staging-and-individualized-treatment
#19
Pengfe Qiu, Rongrong Zhao, Binbin Cong, Guoren Yang, Yanbing Liu, Peng Chen, Xiao Sun, Chunjian Wang, Yongsheng Wang
OBJECTIVE: The aim of this study was to determine the impact of routinely performed internal mammary sentinel lymph node biopsy (IM-SLNB) on the staging and treatment, and to analyze the success rate, complications and learning curve. METHODS: All patients with biopsy-proven breast cancer who underwent sentinel lymph node biopsy between 2012 and 2014 were included in a prospective analysis. Internal mammary sentinel lymph node biopsy (IM-SLNB) was performed in all patients with IM-SLN visualized on preoperative lymphoscintigraphy and/or detected by intraoperative gamma probe detection...
January 2016: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/26762571/aggregate-and-hospital-level-impact-of-national-guidelines-on-diagnostic-resource-utilization-for-children-with-pneumonia-at-children-s-hospitals
#20
REVIEW
Kavita Parikh, Matt Hall, Anne J Blaschke, Carlos G Grijalva, Thomas V Brogan, Mark I Neuman, Derek J Williams, Jeffrey S Gerber, Adam L Hersh, Samir S Shah
BACKGROUND: National guidelines for the management of community-acquired pneumonia (CAP) in children were published in 2011. These guidelines discourage most diagnostic testing for outpatients, as well as repeat testing for hospitalized patients who are improving. We sought to evaluate the temporal trends in diagnostic testing associated with guideline implementation among children with CAP. METHODS: Children 1 to 18 years old who were discharged with pneumonia after emergency department (ED) evaluation or hospitalization from January 1, 2008 to June 30, 2014 at any of 32 children's hospitals participating in the Pediatric Health Information System were included...
May 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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