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Pleural catheter

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https://www.readbyqxmd.com/read/27898215/randomized-trial-of-pleural-fluid-drainage-frequency-in-patients-with-malignant-pleural-effusions-the-asap-trial
#1
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 (IPC) allow patients to drain pleural fluid at home and can lead to auto-pleurodesis. The optimal drainage frequency to achieve auto-pleurodesis and freedom from catheter has not been determined. OBJECTIVE: To determine whether an aggressive daily drainage strategy is superior to the current standard every other day drainage of pleural fluid in achieving auto-pleurodesis...
November 29, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27896665/ultrasound-guided-thoracic-paravertebral-block-by-the-paralaminar-in-plane-approach-using-a-microconvex-array-transducer-methodological-utility-based-on-anatomical-structures
#2
Yasuko Taketa, Taro Fujitani, Yumi Irisawa, Satoko Sudo, Kazushi Takaishi
OBJECTIVE: We evaluated the analgesic feasibility of paralaminar in-plane (PL) approach for ultrasound-guided thoracic paravertebral block (USG-TPVB). As the needle trajectory was expected to be closely affected by the distance from the skin to the lamina-transverse process junction (LTPJ), we examined the correlativity between them on computed tomography (CT) or ultrasonography. METHODS: Thirty-two patients undergoing thoracotomy were recruited. We measured the distances between the skin and LTPJ using preoperative CT (S-L) and procedural ultrasonography (US-L)...
November 28, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27890417/mycobacterium-fortuitum-empyema-associated-with-an-indwelling-pleural-catheter-case-report-and-review-of-the-literature
#3
Paul Blair, Mahdi Moshgriz, Marc Siegel
Mycobacterium fortuitum is a rapidly growing mycobacterium (RGM) that is an uncommon cause of healthcare-associated infections. The most common infections caused by M. fortuitum include skin, soft tissue, and catheter-related infections. Although occasionally cultured from sputum samples, M. fortuitum is a rare cause of pulmonary disease. We report a case of M. fortuitum empyema associated with an infected pleural catheter and review M. fortuitum pulmonary infections.
November 24, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27877066/implantation-of-permanent-pleural-catheter-for-palliation-of-malignant-pleural-effusion
#4
Michelle Meier, Marie Riis Mortensen, Lene Unmack Larsen
PURPOSE: Malignant pleural effusion (MPE) is a disabling condition caused in most instances by far-advanced cancer. The treatment is palliative and should ideally be minimally invasive. The aim of this retrospective study was to evaluate the effectiveness of implantation of a permanent PleurX catheter in the treatment of recurrent MPE in patients with terminal cancer disease. PATIENTS AND METHODS: Eighteen consecutive patients with terminal cancer and MPE, who had a permanent PleurX catheter implanted in the period from February 2014 to August 2015, were retrospectively evaluated...
2016: Cancer Management and Research
https://www.readbyqxmd.com/read/27871587/peripheral-nerve-blocks-in-the-management-of-postoperative-pain-challenges-and-opportunities
#5
REVIEW
Girish Joshi, Kishor Gandhi, Nishant Shah, Jeff Gadsden, Shelby L Corman
Peripheral nerve blocks (PNBs) are increasingly used as a component of multimodal analgesia and may be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). We undertook a qualitative review focusing on sPNB and cPNB with regard to benefits, risks, and opportunities for optimizing patient care. Meta-analyses of randomized controlled trials have shown superior pain control and reductions in opioid consumption in patients receiving PNB compared with those receiving intravenous opioids in a variety of upper and lower extremity surgical procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871519/intrapleural-placement-of-a-thoracic-epidural-catheter-in-a-patient-with-spinal-stenosis
#6
Kiran Belani, Mario Montealegre-Gallegos, Brian Ferla, Robina Matyal
Due to the close proximity of the thoracic epidural space and parietal pleura, pleural puncture with intrapleural catheter placement is a potential complication of thoracic epidural anesthesia. The authors present a case of an obese patient with a history of spinal stenosis that underwent thoracotomy. Repeated failed attempts at epidural anesthesia were complicated by intrapleural placement of the catheter. The patient subsequently developed clinical signs of pneumothorax and required urgent thoracostomy.
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870682/advances-in-interventional-oncology-lung-cancer
#7
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/27866276/manual-intrapleural-saline-flushing-plus-urokinase-a-potentially-useful-therapy-for-complicated-parapneumonic-effusions-and-empyemas
#8
José M Porcel, Horacio Valencia, Silvia Bielsa
PURPOSE: We sought to evaluate the safety profile and effectiveness of manual pleural saline flushing, in addition to urokinase, for managing complicated parapneumonic effusions and empyemas. METHODS: Retrospective comparative review of 23 consecutive patients with complicated parapneumonic effusions or empyemas who received saline flushing plus urokinase through small-bore chest catheters, and 39 who were only treated with fibrinolytics. Both groups had similar baseline characteristics and treatments were mostly protocol-driven...
November 19, 2016: Lung
https://www.readbyqxmd.com/read/27865327/indwelling-pleural-catheters-a-clinical-option-in-trapped-lung
#9
REVIEW
Luca Bertolaccini, Andrea Viti, Simona Paiano, Carlo Pomari, Luca Rosario Assante, Alberto Terzi
Malignant pleural effusion (MPE) symptoms have a real impact on quality of life. Surgical approach through video-assisted thoracic surgery provides a first step in palliation. In patients unfit for general anesthesia, awake pleuroscopy represents an alternative. Sclerosing agents can be administered at the bedside through a chest tube. Ideal treatment of MPE should include adequate long-term symptom relief, minimize hospitalization, and reduce adverse effects. Indwelling pleural catheter (IPC) allows outpatient management of MPE through periodic ambulatory fluid drainage...
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
#10
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/27845052/the-management-of-benign-pleural-effusions-using-indwelling-pleural-catheters-a-systematic-review-and-meta-analysis
#11
Monali Patil, Samjot Singh Dhillon, Kristopher Attwood, Marwan Saoud, Abdul H Alraiyes, Kassem Harris
INTRODUCTION: Indwelling pleural catheter (IPC), which was initially introduced for the management of recurrent malignant effusions, could be a valuable management option for recurrent benign pleural effusions (BPE) in place of chemical pleurodesis. The purpose of this study is to analyze the efficacy and safety of IPC in the management of refractory non-malignant effusions. METHODS: We conducted a systematic review and meta-analysis on the published literature...
November 11, 2016: Chest
https://www.readbyqxmd.com/read/27815709/stage-directed-therapy-of-pleural-empyema
#12
REVIEW
Martin Reichert, Matthias Hecker, Biruta Witte, Johannes Bodner, Winfried Padberg, Markus A Weigand, Andreas Hecker
PURPOSE: Intensivists and surgeons are often confronted with critically ill patients suffering from pleural empyema. Due to it' s multifactorial pathogenesis and etiology, medicals should be sensitized to recognize the different stages of the disease. Besides a whole bundle of different established classification systems, the progress of pleural effusions can be subdivided into the early exudative, the intermediate fibropurulent and the late organized phase according to the classification of the American Thoracic Society...
November 4, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27800290/antibiogram-of-medical-intensive-care-unit-at-tertiary-care-hospital-setting-of-pakistan
#13
Aayesha Qadeer, Aftab Akhtar, Qurat Ul Ain, Shoab Saadat, Salman Mansoor, Salman Assad, Wasib Ishtiaq, Abid Ilyas, Ali Y Khan, Yousaf Ajam
OBJECTIVE:  To determine the frequency of micro-organisms causing sepsis as well as to determine the antibiotic susceptibility and resistance of microorganisms isolated in a medical intensive care unit. MATERIALS AND METHODS:  This is a cross-sectional analysis of 802 patients from a medical intensive care unit (ICU) of Shifa International Hospital, Islamabad, Pakistan over a one-year period from August 2015 to August 2016. Specimens collected were from blood, urine, endotracheal secretions, catheter tips, tissue, pus swabs, cerebrospinal fluid, ascites, bronchoalveolar lavage (BAL), and pleural fluid...
September 29, 2016: Curēus
https://www.readbyqxmd.com/read/27798020/optimum-a-protocol-for-a-multicentre-randomised-controlled-trial-comparing-out-patient-talc-slurry-via-indwelling-pleural-catheter-for-malignant-pleural-effusion-vs-usual-inpatient-management
#14
P Sivakumar, A Douiri, A West, D Rao, G Warwick, T Chen, L Ahmed
INTRODUCTION: The development of malignant pleural effusion (MPE) results in disabling breathlessness, pain and reduced physical capability with treatment a palliative strategy. Ambulatory management of MPE has the potential to improve quality of life (QoL). The OPTIMUM trial is designed to determine whether full outpatient management of MPE with an indwelling pleural catheter (IPC) and pleurodesis improves QoL compared with traditional inpatient care with a chest drain and talc pleurodesis...
October 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27779992/survival-difference-in-patients-with-malignant-pleural-effusions-treated-with-pleural-catheter-or-talc-pleurodesis
#15
Douglas Z Liou, Derek Serna-Gallegos, Joshua L Chan, Jerald Borgella, Shah Akhmerov, Harmik J Soukiasian
Malignant pleural effusions (MPE) are commonly managed with either pleural catheter (PC) or talc pleurodesis (TP). The aim of this study was to compare survival in MPE patients treated with either PC or TP. A retrospective review of our cancer center database was performed. Patients with metastatic cancer and MPE were analyzed. Demographic and clinical data were tabulated and compared. A total of 238 patients with MPE treated by either PC or TP were included. Of these, 79 patients comprised the PC group and 159 the TP group...
October 2016: American Surgeon
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/27661554/-a-review-on-thoracic-ultrasound
#17
Sebastián Fernández-Bussy, Gonzalo Labarca, Mario Lanza, Erik Folch, Adnan Majid
The use of thoracic ultrasound as a diagnostic tool in the emergency department, intensive care unit or in patients with pulmonary diseases is increasing steadily. It is used to guide percutaneous tracheostomies, to assess pleural effusions, to rule out pneumothorax, and to guide the placement of endovascular and pleural catheters. It is also useful in the assessment of patients with dyspnea. The aim of this review is to provide the practical and technical basics for the use of this diagnostic tool among internists and specialists in pulmonary diseases...
July 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/27648553/therapy-of-645-children-with-parapneumonic-effusion-and-empyema-a-german-nationwide-surveillance-study
#18
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/27643771/case-234-neuropathic-spondyloarthropathy
#19
Ramez R Hanna, Nicholas Kolanko, Carlos Torres
History A 70-year-old woman presented to a peripheral hospital with signs and symptoms of acute chronic obstructive pulmonary disease (COPD) exacerbation. The patient also reported acute on chronic onset of thoracolumbar back pain over a period of 24 hours. She denied any history of recent trauma or intravenous drug use. She did not have any long-term indwelling catheters. The patient's medical history was also complicated by stage 4 renal failure from long-standing type II diabetes, hypertension, iron deficiency anemia, aortic stenosis, and prior bariatric surgery...
October 2016: Radiology
https://www.readbyqxmd.com/read/27636673/measurement-of-pleural-pressure-swings-with-a-fluid-filled-esophageal-catheter-vs-pulmonary-artery-occlusion-pressure
#20
S Verscheure, P B Massion, S Gottfried, P Goldberg, L Samy, P Damas, S Magder
PURPOSE: Pleural pressure measured with esophageal balloon catheters (Peso) can guide ventilator management and help with the interpretation of hemodynamic measurements, but these catheters are not readily available or easy to use. We tested the utility of an inexpensive, fluid-filled esophageal catheter (Peso) by comparing respiratory-induced changes in pulmonary artery occlusion (Ppao), central venous (CVP), and Peso pressures. METHODS: We studied 30 patients undergoing elective cardiac surgery who had pulmonary artery and esophageal catheters in place...
August 31, 2016: Journal of Critical Care
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