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"Pneumothorax" AND ("Intercostal Catheter" OR "ICC" OR "Drain" OR "Underwater Seal" OR "UWSD" OR "Needle Decompression" OR "Thoracostomy")

Robert J Lentz, Andrew D Lerner, Jasleen K Pannu, Christopher M Merrick, Lance Roller, Charla Walston, Sarah Valenti, Tracey Goddard, Heidi Chen, John T Huggins, Otis B Rickman, Lonny Yarmus, Ioannis Psallidas, Najib M Rahman, Richard W Light, Fabien Maldonado
BACKGROUND: In patients with non-expandable lung, removal of pleural fluid can result in excessively negative pleural pressure, which is associated with chest discomfort, pneumothorax, and re-expansion pulmonary oedema. Pleural manometry is widely used to safeguard against pressure-related complications during thoracentesis despite little evidence to support the approach. We investigated whether monitoring of pleural pressure with manometry during thoracentesis could protect against complications compared with assessment of symptoms alone...
February 13, 2019: Lancet Respiratory Medicine
M F Sazzad, M A Uddin, M A Imran, A M Ansary, S A Musa, H Saha, M M Rahman, M R Hoque, M N Islam, S Sarkar, G Tanchangya, A K Pal, I Alam, M S Ershad, M Kamruzzaman, S Sultana
We examined the hypothesis that the cross mattress for chest drain insertion site security is better than that of polypropylene horizontal mattress in chest trauma patient required tube thoracostomy at the Department of Casualty Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2016 to June 2016. Accordingly we prospectively studied 50 consecutive patients who needed chest tube insertion. In 25 consecutive cases chest drain insertion site was secured with polypropylene horizontal mattress technique (Control- Group A) and another 25 consecutive patients had a cross-mattress with non-absorbable suture materials (Experimental- Group B)...
January 2019: Mymensingh Medical Journal: MMJ
Richard N Lesperance, Colin M Carroll, James K Aden, Jason B Young, Timothy C Nunez
Tension pneumothorax is commonly treated with needle decompression (ND) at the 2nd intercostal space midclavicular line (2nd ICS MCL) but is thought to have a high failure rate. Few studies have attempted to directly measure the failure rate in patients receiving the intervention. We performed a retrospective analysis of 10 years of patients receiving prehospital ND. CT scans were reviewed to record the location of catheters left indwelling and the proportion of patients who did not have any pneumothorax. Chest wall thickness was measured on both injured and uninjured sides at the 2nd ICS MCL and compared with the recommended alternative, the 5th ICS anterior axillary line (5th ICS AAL)...
November 1, 2018: American Surgeon
Noor Sameh Darwich, Robert L Tyrrell
Bilateral pneumothoraces following unilateral subclavian vein cannulation is a rare complication. It is usually associated with an intrapleural communication which can be congenital or formed following cardiothoracic and mediastinal surgeries, or trauma. The term Buffalo chest was used to define a single chest cavity with no anatomic separation of the two hemithoraces. It is called Buffalo chest because this unique chest anatomy of the American buffalo, or bison, helped hunters to kill them with a single arrow to the chest because the resultant pneumothorax could collapse both lungs...
2019: Respiratory Medicine Case Reports
Matteo Bruschettini, Olga Romantsik, Simona Zappettini, Colm Pf O'Donnell, Maria Grazia Calevo
BACKGROUND: Pneumothorax occurs more frequently in the neonatal period than at any other time of life and is associated with increased mortality and morbidity. It can be treated with either aspiration with a syringe (using a needle or an angiocatheter) or a chest tube inserted in the anterior pleural space and then connected to a Heimlich valve or an underwater seal with continuous suction. OBJECTIVES: To compare the efficacy and safety of needle aspiration (either with immediate removal of the needle or with the needle left in situ) to intercostal tube drainage in the management of neonatal pneumothorax (PTX)...
February 1, 2019: Cochrane Database of Systematic Reviews
James Michael Evans, Alistair Ray, Megan Dale, Helen Morgan, Paul Dimmock, Grace Carolan-Rees
The Thopaz+ portable digital system was evaluated by the Medical Technologies Advisory Committee (MTAC) of the National Institute for Health and Care Excellence (NICE). The manufacturer, Medela, submitted a case for the adoption of Thopaz+ that was critiqued by Cedar, on behalf of NICE. Due to a lack of clinical evidence submitted by the manufacturer, Cedar carried out its own literature search. Clinical evidence showed that the use of Thopaz+ led to shorter drainage times, a shorter hospital stay, lower rates of chest drain re-insertion and higher patient satisfaction compared to conventional chest drainage when used in patients following pulmonary resection...
January 23, 2019: Applied Health Economics and Health Policy
Yusuf Kantar, Polat Durukan, Leyla Hasdıraz, Necmi Baykan, Şule Yakar, Nesij Doğan Kaymaz
OBJECTIVES: The aim of this study was to determine the demographic and clinical characteristics of patients who underwent tube thoracostomy in the emergency department (ED). The secondary aim of the study was to evaluate parameters such as the diagnosis for which the patients underwent tube thoracostomy, the imaging techniques used during diagnosis, and complications related to the procedure. MATERIALS AND METHODS: This prospective study was conducted in the ED between June 1, 2015 and May 31, 2016...
January 1, 2019: Turkish Thoracic Journal
Muhammad Asghar Nawaz, Denish Apparau, Joseph Zacharias, Michael Shackcloth
BACKGROUND: Pneumothorax is a common condition with various management options. We aimed to determine the current surgical practice in the United Kingdom. METHOD: An online questionnaire regarding surgical strategy was sent to all consultants who were members of the Society for Cardiothoracic Surgery (80 thoracic). RESULTS: Fifty-six consultants, mainly thoracic, responded to the survey. Video-assisted thoracoscopic surgery was unanimously the preferred approach, the majority (59%) using 3 ports...
January 19, 2019: Asian Cardiovascular & Thoracic Annals
Wong Hoi She, Kenneth S H Chok, Iris W S Li, Ka Wing Ma, Sui Ling Sin, Wing Chiu Dai, James Y Y Fung, Chung Mau Lo
BACKGROUND: Pneumocystis pneumonia (PCP) is a common opportunistic infection caused by Pneumocystis jirovecii. Its incidence at 2 years or more after liver transplant (LT) is < 0.1%. PCP-related spontaneous pneumothorax and/or pneumomediastinum is rare in patients without the human immunodeficiency virus, with an incidence of 0.4-4%. CASE PRESENTATION: A 65-year-old woman who had split-graft deceased-donor LT for primary biliary cirrhosis developed fever, dyspnea and dry coughing at 25 months after transplant...
January 18, 2019: BMC Infectious Diseases
S Kepka, J C Dalphin, J B Pretalli, A L Parmentier, D Lauque, G Trebes, F Mauny, T Desmettre
BACKGROUND: Management of spontaneous pneumothorax (SP) is still subject to debate. Although encouraging results of recent studies about outpatient management with chest drains fitted with a one-way valve, no data exist concerning application of this strategy in real life conditions. We assessed how SP are managed in Emergency departments (EDs), in particular the role of outpatient management, the types of interventions and the specialty of the physicians who perform these interventions...
January 11, 2019: BMC Emergency Medicine
Mahdi Malekpour, Kenneth Widom, James Dove, Joseph Blansfield, Mohsen Shabahang, Denise Torres, Jeffrey L Wild
AIM: To investigate the hemothorax size for which tube thoracostomy is necessary. METHODS: Over a 5-year period, we included all patients who were admitted with blunt chest trauma to our level 1 trauma center. Focus was placed on identifying the hemothorax size requiring tube thoracostomy. RESULTS: A total number of 274 hemothoraces were studied. All patients with hemothoraces measuring above 3 cm received a chest tube. The 50% predicted probability of tube thoracostomy was 2 cm...
December 28, 2018: World Journal of Radiology
Zhun Wei, Dong Liu, Xudong Chen
Deep learning has recently been applied to electrical impedance tomography (EIT) imaging. Nevertheless, there are still many challenges that this approach has to face, e.g., targets with sharp corners or edges cannot be well recovered when using circular inclusion training data. This paper proposes an iterative-based inversion method and a convolutional neural network (CNN)-based inversion method to recover some challenging inclusions such as triangular, rectangular, or lung shapes, where the CNN-based method uses only random circle or ellipse training data...
January 9, 2019: IEEE Transactions on Bio-medical Engineering
Savo Bou Zein Eddine, Kelly A Boyle, Christopher M Dodgion, Christopher S Davis, Travis P Webb, Jeremy S Juern, David J Milia, Thomas W Carver, Marshall A Beckman, Panna A Codner, Colleen Trevino, Marc A de Moya
INTRODUCTION: As more pneumothoraxes (PTX) are being identified on chest computed tomography (CT), the empiric trigger for tube thoracostomy (TT) versus observation remains unclear. We hypothesized that PTX measuring ≤35 mm on chest CT can be safely observed in both penetrating and blunt trauma mechanisms. METHODS: A retrospective review was conducted of all patients diagnosed with PTX by chest CT between January 2011 and December 2016. Patients were excluded if they had an associated hemothorax, an immediate TT (TT placed before the initial chest CT), or if they were on mechanical ventilation...
January 8, 2019: Journal of Trauma and Acute Care Surgery
Maria J Mandt, Kari Hayes, Fred Severyn, Kathleen Adelgais
OBJECTIVE: Needle thoracostomy is a life-saving procedure. Advanced Trauma Life Support guidelines recommend insertion of a 5 cm, 14-gauge needle for pneumothorax decompression. High-risk complications can arise if utilizing an inappropriate needle size. No study exist evaluating appropriate needle length in pediatric patients. Utilizing computed tomography (CT), we determined the needle length required to access the pleural cavity in children matched to Broselow™ Pediatric Emergency Tape color...
January 9, 2019: Prehospital Emergency Care
Eiji Yamada, Natsumi Ohno, Takashi Yoshioka, Masahiko Muro
A 69-year-old man who arrived at our hospital by ambulance with dyspnea was diagnosed with pneumothorax. The chest was drained, but the left lung failed to expand due to air leakage. A pulmonary fistula in the left lower lobe identified by video-assisted thoracic surgery was repaired. Postoperative chest radiography showed inadequate expansion of the left upper lobe. Bronchoscopy revealed an obstruction of the left upper bronchus that was pathologically diagnosed as squamous cell carcinoma. Enhanced computed tomography revealed a central tumor with atelectasis of the left upper lobe, and a stained node in the left lower lobe...
December 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
M Ghahramanifar, M Haghani, A Ghadimi Moghadam, A Haghani, A K Ghadimi Moghadam
Chest tube is a flexible plastic tube used to discharge secretion in the cavity between the lungs and chest named pleural cavity. Normally, there is a small amount of fluid in the cavity between the lungs and chest; This fluid helps the movement of lungs during breathing without abrasion. Entrance of bit of air, blood or pus because injury in the pleural cavity can prevent the lungs from fully opening. Full or partial collapse of the lungs makes breathing difficult and can lead to respiratory arrest; putting chest tube in the pleural cavity causes the discharge of secretion and helps patients comfort...
December 2018: Journal of Biomedical Physics & Engineering
Christian S McEvoy, Matthew L Leatherman, Jenny M Held, Laura M Fluke, Robert L Ricca, Travis Polk
BACKGROUND: The 14-gauge (14G) angiocatheter (AC) has an unacceptably high failure rate in treatment of tension pneumothorax (tPTX). Little is known regarding the interplay among hemorrhage, hemothorax (HTX), and tPTX. We hypothesized that increased hemorrhage predisposes tension physiology and that needle decompression fails more often with increased HTX. METHODS: This is a planned secondary analysis of data from our recent comparison of 14G AC with 10-gauge (10G) AC, modified 14G Veress needle, and 3mm laparoscopic trocar conducted in a positive pressure ventilation tension hemopneumothorax model using anesthetized swine...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Andrei Roman, Patriciu Achimas-Cadariu, Bogdan Fetica, Vlad Gata, Andrada Seicean
Background and aims: Despite their usefulness, CT-guided procedures have a low profile in Romania. The current study has the purpose of describing a first experience in performing these procedures. Methods: Tumors and fluid collections that were inaccessible for biopsy or drainage by ultrasound or endoscopic guidance were included. The procedures were performed using a 64-slice GE Optima CT660 CT scanner. The biopsies were carried out using the coaxial technique with an 18 G semiautomatic needle...
October 2018: Clujul Medical (1957)
Julia Wälscher, Benjamin Groß, Ralf Eberhardt, Claus Peter Heussel, Monika Eichinger, Arne Warth, Felix Lasitschka, Felix J F Herth, Michael Kreuter
BACKGROUND: Transbronchial cryobiopsy (cTBB) may offer an alternative to surgical lung biopsy (SLB) for histopathological diagnosis of interstitial lung diseases (ILDs). However, real-life experience is limited, although case series are increasingly reported. OBJECTIVES: We aimed to evaluate the value of cTBB performed under real-life conditions in a tertiary care center for ILDs. METHODS: Data on all patients undergoing a cTBB for evaluation of suspected ILD between October 2015 and January 2017 were included in this retrospective case series...
December 14, 2018: Respiration; International Review of Thoracic Diseases
Christopher Kelly, Mark Carlberg, Troy Madsen
Spontaneous pneumothorax (SP) is a relatively common pathology in emergency medicine; however, scant information is published regarding SPs developing tension physiology in the literature. Risk factors for spontaneous pneumothorax include smoking, family history, and underlying lung disease such as chronic obstructive lung disease (COPD), cystic fibrosis, tuberculosis, among others. Treatment often involves conservative management, needle aspiration, catheter placement, or tube thoracostomy. Tension pneumothorax, however, is a life threatening condition requiring emergent intervention...
January 2019: American Journal of Emergency Medicine
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