Background: Little data exist examining the impact of positive pressure ventilation on safe thoracostomy tube removal. We sought to evaluate the impact of positive-pressure ventilation (PPV) on recurrent pneumothoraces (PTX) after removal of thoracostomy tubes (TT).
Methods: A retrospective cohort analysis was performed evaluating all trauma patients requiring TT drainage of PTX or hemothoraces during a 3-year period. All chest radiographs before and after TT removal were reviewed to identify PTX recurrence. The principle outcome was recurrent PTX after TT removal. The 95% confidence intervals were calculated to assess for significance.
Results: We studied 234 TT removals in 190 patients. One hundred thirty-six (58%) TTs were removed under PPV. PTX recurred in 15 (11%) and 6 (4%) required reinsertion. In 10 patients (7.4%), there was a radiographically stable small PTX before and after removal not requiring TT reinsertion. In comparison, 98 (42%) TTs were removed under spontaneous ventilation. PTX recurred in 16 (16%) and 3 (3%) required reinsertion. There were 25 (25.5%) stable small PTXs before and after removal. The overall recurrence rate difference was -5.3% (confidence interval: -14.8 to 3.5) and reinsertion rate difference was 1.35% (confidence interval: -4.7 to 6.6).
Conclusions: The rate of recurrent PTX or TT replacement after removal is not associated with PPV status. The slightly lower recurrence rate on PPV combined with the smaller proportion of patients with stable small PTX before removal may reflect more careful clinician selection of ideal patients or technique of TT removal among patients on PPV. Prospective data are needed to clarify these associations.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/TA.0b013e3181a5973c | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Potential benefits of intraoperative parathyroid autofluorescence imaging in a patient with multiple endocrine neoplasia type 1 and hyperparathyroidism - A case report.
Int J Surg Case Rep
January 2025
Department of Otorhinolaryngology, Aarhus University Hospital, Aarhus N, Denmark.
Introduction And Importance: Primary hyperparathyroidism (PHPT) is a frequent complication to multiple endocrine neoplasia type 1 (MEN1), presenting challenges due to increased risk of multi-gland disease and recurrence post parathyroidectomy (PTX). This case report examines the management of PHPT in a MEN1 patient, emphasizing possible benefits from intraoperative parathyroid autofluorescence imaging (AF).
Case Presentation: A 21-year-old woman with MEN1 presented with mild hyperparathyroidism symptoms in 2014.
Effectiveness of Track Cauterization in Reduction of Adverse Events for Lung Microwave Ablation.
J Vasc Interv Radiol
January 2025
Department of Radiological Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.
Article Synopsis
- The study aimed to assess how effective track cautery is during lung microwave ablation (MWA) in minimizing adverse events after the procedure.
- A total of 365 MWA sessions were analyzed, comparing patients who underwent track cautery during antenna removal to those who did not, evaluating post-procedural complications like pneumothorax and pleural effusion.
- Results indicated that track cautery significantly reduced rates of enlarging pneumothorax, delayed pneumothorax, and pleural effusion, while factors like emphysema and tumor size were linked to higher adverse event rates.
Bilateral orthogonality generative acquisitions method for homogeneous images using parallel transmission at 7 T.
Magn Reson Med
March 2025
UT Southwestern Medical Center, Dallas, Texas, USA.
Article Synopsis
- A novel method for generating homogeneous images in MRI has been developed using bilateral orthogonality generative acquisitions, specifically targeting corrections for transmit field inhomogeneity in high-field 7 T systems with parallel transmission (pTx) technology.
- This method utilizes four low-angle gradient-echo (GRE) acquisitions, including two in circularly polarized mode and two with altered transmit phases, to improve image quality across various pTx system setups, including dual-channel and eight-channel configurations.
- Results show that the new approach provides superior contrast, especially in low-intensity areas, making it a straightforward and effective solution for obtaining consistent brain images compared to existing methods like TIAMO.
Purpose: Chemical exchange saturation transfer (CEST) measurements at ultra-high field (UHF) suffer from strong saturation inhomogeneity. Retrospective correction of this inhomogeneity is possible to some extent, but requires a time-consuming repetition of the measurement. Here, we propose a calibration-free parallel transmit (pTx)-based saturation scheme that homogenizes the saturation over the imaging volume, which we call PUlse design for Saturation Homogeneity utilizing Universal Pulses (PUSHUP).
View Article and Find Full Text PDFEvaluation of a Novel Needle Decompression Device Against Standard of Care: A Cadaveric Model.
Mil Med
September 2024
Department of Trauma and Emergency Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
Article Synopsis
- Pneumothorax (PTX) is a significant concern in trauma centers, with up to 20% of patients presenting with it, and about 5% of combat casualties dying from tension PTX (tPTX), making rapid diagnosis and treatment critical.
- The Donaldson Decompression Needle (DDN) is designed to improve safety during decompression by preventing over-insertion and reducing the risk of causing new injuries while still effectively alleviating pressure in the chest.
- A study comparing the DDN to a standard needle found that while setup times were similar, the DDN had a significantly longer decompression time, highlighting a trade-off between safety and speed in handling PTX.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!