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Article Synopsis
- Tube thoracostomy (TT) is used to drain fluid from the pleural cavity, but improper tube positioning occurs in 30% of cases, which can complicate treatment.* -
- In a study involving 650 TT procedures on cadaver torsos, two techniques ("head" vs. "bed" direction) were compared to see which resulted in fewer instances of tube placement in lung fissures.* -
- Results showed that tubes aimed "toward the bed" had a significantly lower placement rate in fissures (13%) compared to the "head" positioning (41%), suggesting that this technique could improve clinical outcomes.*
Risk factors affecting the development of pneumothorax in patients followed up in intensive care with a diagnosis of COVID-19.
BMC Infect Dis
November 2024
Department of Critical Care, Marmara University Pendik Training and Research Hospital, Pendik, Istanbul, Turkey.
Article Synopsis
- Pneumothorax is a rare but serious complication of COVID-19 that leads to worse patient outcomes, requiring more respiratory support, longer hospital stays, and increased mortality.
- This observational study reviewed 100 patients in the COVID-19 ICU who underwent tube thoracostomy due to pneumothorax, analyzing their demographics and clinical data.
- Findings indicated that the majority of patients were older males (median age 68), with high rates of intubation and significant respiratory support needed, highlighting critical factors that could predict mortality in these cases.
Prehospital Trauma Compendium: Traumatic Pneumothorax Care: Position Statement and Resource Document of NAEMSP.
Prehosp Emerg Care
December 2024
LA County EMS Agency, Santa Fe Springs, California.
Article Synopsis
- EMS clinicians handle traumatic pneumothoraxes, including simple ones that are less severe and tension pneumothoraxes that can lead to serious complications like shock.
- The most common treatment for tension pneumothorax in EMS is needle thoracostomy, but its frequent misapplication and low success rates have raised concerns about its effectiveness.
- The National Association of EMS Physicians conducted a literature review to create evidence-based recommendations for managing traumatic pneumothoraxes, addressing the need for proper decompression techniques and clarifying procedures for open pneumothoraxes.
Successful Needle Aspiration of a Traumatic Pneumothorax: A Case Report and Literature Review.
Medicina (Kaunas)
March 2024
Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy.
Article Synopsis
- Traumatic pneumothorax is common in severe injuries, often requiring emergency treatments like thoracostomy, but recent studies suggest stable patients may benefit from less invasive options like observation or needle aspiration.
- A case study of a 52-year-old woman with a large (55 mm) traumatic PTX shows that after aspirating 1500 mL of air, her condition improved significantly, allowing for her quick discharge.
- The article reviews existing literature on the conservative management of traumatic PTX and emphasizes that even large pneumothoraxes can be resolved effectively with needle aspiration in hemodynamically stable patients, thus reducing the need for more invasive procedures.
Minimally invasive management of thoracic trauma: current evidence and guidelines.
Trauma Surg Acute Care Open
April 2024
Duke University Hospital, Durham, North Carolina, USA.
Minimally invasive procedures are being increasingly proposed for trauma. Injuries to the chest wall and/or lung have historically been managed by drainage with a large bore thoracostomy tube, while cardiac injuries have mandated sternotomy. These treatments are associated with significant patient discomfort.
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