2,267 results match your criteria: "Tube Thoracostomy"
Traumatic Atrial Septal Defect with Tricuspid Regurgitation Following Blunt Chest Trauma Presenting as Hypoxemia: A Case Report.
Clin Pract Cases Emerg Med
November 2024
Sher-i-Kashmir Institute of Medical Sciences Soura, Department of Anesthesia, Srinagar, Jammu and Kashmir, India.
Introduction: Although myocardial injury is common after blunt chest trauma, tricuspid valve injury associated with traumatic atrial septal defect resulting in acute hypoxia is an infrequent event. We report an unusual case of blunt chest trauma referred to us for unexplained hypoxemia, emphasizing the unusual nature of injury and the importance of comprehensive cardiac evaluation in such cases.
Case Report: A 35-year-old male presented to the emergency department after falling from a tree from an approximate height of 15 feet.
A Randomized Non-Inferiority Clinical Trial of 14Fr Thal versus 28Fr Tube Thoracostomy for Traumatic Hemothorax.
Am Surg
December 2024
Department of Surgery, Wake Forest School of Medicine, Atrium Health Carolinas Medical Center, Charlotte, NC, USA.
Background: The traditional treatment of traumatic hemothorax (HTX) is large bore chest tubes (CT) ≥28Fr. Recent evidence shows 14Fr pigtail catheters are as effective in drainage of HTX as larger CT. However, this has not been shown in 14Fr Thal tubes, a straight chest tube placed utilizing Seldinger technique.
View Article and Find Full Text PDFA single left fourth intercostal thoracotomy approach for resolution of idiopathic chylothorax with thoracic duct ligation and pericardiectomy: a preliminary clinical study in two dogs.
Front Vet Sci
December 2024
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States.
Open surgical treatment of idiopathic chylothorax via thoracic duct ligation and pericardiectomy requires a lengthy procedure with two thoracotomy incisions. The objectives of this report were to describe an approach for thoracic duct ligation and pericardiectomy via a single thoracotomy at the left fourth intercostal space and to describe the clinical outcome in two dogs with idiopathic chylothorax. Dogs were prospectively enrolled in a pilot study to evaluate the clinical efficacy of thoracic duct ligation at the left fourth intercostal space, combined with subphrenic pericardiectomy performed through the same incision.
View Article and Find Full Text PDFSelf-Directed Skills Laboratories Increase Emergency Medicine Physician Confidence in High-Acuity, Low-Opportunity Procedures.
Mil Med
December 2024
Department of Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA.
Introduction: The critical role of emergency physicians in military settings underscores the necessity for a broad and proficient skill set, especially in life-saving procedures such as thoracostomies, endotracheal intubations, and cricothyrotomies, to maintain combat readiness. The current peacetime phase, however, presents challenges in maintaining these skills because of decreased exposure to high-acuity medical scenarios. This decrease in exposure jeopardizes skills retention among military emergency medicine physicians, highlighted by studies showing a significant decline in performance over time because of reduced practice.
View Article and Find Full Text PDFPYOPNEUMOTHORAX CAUSED BY PREVOTELLA INTERMEDIATA: AN INTERESTING CASE REPORT.
J Ayub Med Coll Abbottabad
December 2024
Department of Pulmonology.
Article Synopsis
- Prevotella species are typically harmless bacteria found in the intestines and mouth but can cause infections in immune-compromised individuals.
- A 35-year-old man presented with high fever and chest pain, showing signs of an infection with severe respiratory symptoms and poor oral hygiene.
- After medical imaging revealed a loculated pyopneumothorax, a chest tube was inserted, draining foul-smelling pus that tested positive for Prevotella Intermediata, which responded well to treatment.
Assessing the evolution of pre-hospital combat casualty care: A comparative study of two conflicts a decade apart.
Am J Emerg Med
November 2024
Israel Defense Forces, Medical Corps, Kiryat Ono, Israel; The Institute of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
Article Synopsis
- Combat casualty care has improved due to evidence-based protocols, with a study comparing prehospital care and outcomes of patients from conflicts in 2014 and 2023 in southern Israel.
- The study found that the number of evacuated patients increased significantly from 251 in 2014 to 940 in 2023, while the time to hospital arrival decreased.
- There was an increase in the proportion of severely injured patients, a decrease in some advanced prehospital interventions, and an increase in prehospital blood transfusions, but in-hospital mortality rates remained stable across both conflicts.
A Pilot Study of a Simulation-Based Mastery Learning Procedural Curriculum for Pediatric Emergency Medicine Fellows.
Pediatr Emerg Care
December 2024
From the Departments of Emergency Medicine.
Article Synopsis
- Pediatric emergency medicine (PEM) fellows need to master high-risk procedures like central venous catheter placement, endotracheal intubation, and tube thoracostomy, which are often not taught during residency.
- A simulation-based mastery learning (SBML) curriculum was implemented for teaching key procedures like lumbar puncture and endotracheal intubation, including assessments and hands-on practice.
- After training, all fellows achieved competency in critical procedures, highlighting SBML as an effective method for enhancing procedural skills in PEM training.
Impact of Deep Learning-Based Computer-Aided Detection and Electronic Notification System for Pneumothorax on Time to Treatment: Clinical Implementation.
J Am Coll Radiol
November 2024
Professor, Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Article Synopsis
- The study aimed to evaluate how a deep learning computer-aided detection (DL-CAD) and an electronic notification system (ENS) impacted the time it takes to treat patients suspected of having pneumothorax (PTX) in a real clinical setting.
- After implementing the DL-CAD-ENS in May 2022 at a large hospital, researchers compared treatment times between two groups: one using both DL-CAD and ENS, and another using only DL-CAD, analyzing data from January 2018 to April 2023.
- Results showed a significant decrease in time to provide oxygen therapy for the group using DL-CAD-ENS compared to the CAD-only group, but no significant changes in treatment times for other interventions
Anaesthetic management of a breast cancer patient with cardiac tamponade and bilateral vocal cord paralysis.
BMJ Case Rep
November 2024
Department of Anesthesiology, Philippine General Hospital, University of the Philippines Manila, Manila, Metro Manila, Philippines.
Article Synopsis
- Metastatic breast cancer can lead to unusual complications, such as cardiac tamponade and bilateral vocal cord paralysis, as shown in a case of an elderly patient who had prior surgery for breast cancer.
- The patient underwent multiple surgical procedures, including thoracotomy and tracheostomy, due to these complications, which posed significant challenges for anaesthesia management.
- This case underscores the seriousness of advanced breast cancer and the need for careful consideration of anaesthetic strategies in similar situations.
Extra-skeletal Ewing sarcoma of the diaphragm in a young female: a case report.
Ann Med Surg (Lond)
November 2024
Departement of Histopathology, Shifa International Hospital, Islamabad, Pakistan.
Article Synopsis
- - Extra-skeletal Ewing sarcoma (EES) is a rare but aggressive tumor that affects soft tissue and is part of the primitive neuroectodermal tumors family, with only about 30 documented cases.
- - A 20-year-old female patient experienced symptoms like shortness of breath and chest pain, leading to the discovery of a soft tissue mass that was eventually diagnosed as Ewing sarcoma through biopsy.
- - Early detection and a multidisciplinary treatment approach, including surgical resection and chemotherapy, are crucial for improving patient outcomes, as EES often presents with non-specific symptoms and has a poor prognosis.
Chest Tubes and Pleural Drainage: History and Current Status in Pleural Disease Management.
J Clin Med
October 2024
Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK.
Article Synopsis
- Thoracostomy and chest tube placement are essential procedures for managing pleural diseases caused by fluid or air buildup in the pleural cavity, with historic methods evolving significantly since Hippocrates.
- The development of closed drainage systems in the 19th century and advancements in materials, such as plastic and the Heimlich valve, have improved chest tube designs and functionality.
- Modern techniques include various tube designs, digital monitoring systems, and the use of pleurodesis to prevent complications, ensuring that chest tube insertion continues to play a vital role in treating pleural conditions effectively.
An alternative to chest tube thoracostomy equipment.
Turk Gogus Kalp Damar Cerrahisi Derg
July 2024
Department of Thoracic Surgery, Erzurum City Hospital, Erzurum, Türkiye.
Thoracic irrigation for traumatic hemothorax: A systematic review and meta-analysis.
J Trauma Acute Care Surg
November 2024
From the Divisions of Trauma, Surgical Critical Care, and Burns, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, Miami, Florida.
Article Synopsis
- Traumatic hemothoraces (HTXs) are common injuries managed with tube thoracostomy (TT), but retained HTX can complicate recovery, potentially leading to conditions like fibrothorax or empyema.
- The study reviewed six research studies involving 1,319 trauma patients and found that those who received thoracic irrigation during TT had a significantly lower failure rate (10.7% vs. 18.2%) and shorter hospital stays.
- The conclusion suggests that concurrent TT and thoracic irrigation can reduce retained HTX rates, although more randomized studies are needed to establish formal treatment guidelines.
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.
Thoracic trauma in the geriatric population and possible preventive measures: a retrospective analysis of 261 cases.
Turk J Med Sci
October 2024
Department of Thoracic Surgery, Ankara Etlik City Hospital, Ankara, Turkiye.
Article Synopsis
- The study focuses on elderly patients (65+) who experienced thoracic trauma, particularly highlighting their increased vulnerability to falls due to age-related health issues.
- Among 261 patients analyzed, 52% had indoor trauma, and those with indoor accidents had a higher fall risk score compared to those with outdoor accidents.
- The findings suggest a need for targeted measures to reduce trauma-related health problems in the geriatric population as it continues to grow, emphasizing both health risks and potential financial costs.
Can Concurrent Traumatic Hemopneumothorax be Safely Observed?
J Surg Res
December 2024
Division of Trauma & Critical Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address:
Article Synopsis
- The study investigates the safety of observing patients with small concurrent traumatic hemopneumothorax (HPTX), finding that 74% of patients were managed with observation instead of immediate tube thoracostomy (TT).
- Results indicate that patients under observation experienced lower rates of pulmonary complications and shorter hospital stays compared to those who underwent early TT.
- However, observation had a notable failure rate, with many patients needing further intervention, but those who did fail showed outcomes similar to those who got immediate TT.
A Unique Complication of Pigtail Pleural Catheter Placement.
Cureus
September 2024
Emergency Medicine, Christus Health/Texas A&M University School of Medicine, Corpus Christi, USA.
Article Synopsis
- Pigtail pleural catheters are gaining popularity as a less painful and equally effective option compared to traditional large-bore thoracostomy tubes.
- This report details the case of a 48-year-old man who needed a pigtail catheter for treating parapneumonic pleural effusion due to his worsening health.
- Despite the procedure's advantages, the patient experienced significant complications afterward.
Utilizing Un-enhanced Chest Computed Tomography Screening for Blunt Trauma Surgery Decisions.
Cureus
September 2024
Surgery, Ghurki Trust Teaching Hospital, Lahore, PAK.
Article Synopsis
- Blunt chest trauma is a significant medical condition requiring quick evaluation to decide on possible surgery, and non-contrast CT scans are more effective than standard chest X-rays for detecting injuries.
- The study at Lady Reading Hospital involved 246 patients, mostly males aged 50 and older, with road traffic accidents being the primary cause of injury; non-contrast CT revealed more cases of hemopneumothorax compared to chest X-rays.
- Findings highlight that non-contrast CT scans are a reliable diagnostic method for blunt chest trauma, influencing treatment decisions and aligning with existing research.
Efficacy of slow negative pleural suction in thoracic trauma patients undergoing tube thoracostomy-A randomised clinical trial.
Injury
September 2024
Department of General Surgery, All India Institute of Medical Sciences, Jodhpur, India. Electronic address:
Article Synopsis
- Thoracic injuries are common in polytrauma patients, particularly from road traffic accidents, with rib fractures and pneumothorax often requiring tube thoracostomy, yet there is little agreement on post-insertion care, especially about negative pleural suction.
- A study conducted in a western Indian hospital randomized 64 adult patients with thoracic trauma to either slow negative suction or conventional drainage, aiming to compare outcomes like time to chest tube removal and hospital stay.
- Results indicated that those in the slow negative suction group had significantly shorter chest tube duration and hospital stays without added discomfort, with low mortality observed in both groups.
Effects of post rib plating tube thoracostomy output on the need for thoracic re-intervention: Does the volume matter?
Injury
September 2024
University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care. Electronic address:
Article Synopsis
- The study investigates the timing of tube thoracostomy (TT) removal after surgical stabilization of rib fractures (SSRF) and its relation to the need for subsequent thoracic reinterventions in blunt trauma patients.
- Out of 133 patients analyzed between 2018 and 2023, 17.3% required thoracic reinterventions, and these patients had higher injury severity scores and longer TT durations.
- The findings indicate that TT output before removal did not predict the need for reintervention, suggesting that there may not be a specific output threshold to guide the timing of TT removal after SSRF.
Article Synopsis
- The study explored a new chest tube placement technique using the sternum, aiming to lower the risk of misplacement and complications in chest trauma patients.
- Researchers analyzed data from 184 patients treated at a Korean trauma center, comparing traditional methods of tube placement to the sternum-based method using CT scans.
- Findings suggested that the sternum method provides higher accuracy in ensuring that the tube does not pass the diaphragm, leading to a more effective and safer thoracostomy approach.
Real-world effectiveness and safety of handheld ultrasound in pleural procedures.
Monaldi Arch Chest Dis
October 2024
Department of Medicine, Aga Khan University, Karachi.
Article Synopsis
- Using handheld ultrasounds for pleural procedures can help reduce complications during the procedures.
- In a study, 332 procedures were done with handheld ultrasounds, and almost all (99.1%) were successful with only a few patients having minor complications.
- The study showed that handheld ultrasounds are not only effective but also safe, even for patients who are on certain medications or have special conditions.
Recommended recumbency to avoid insertional complications during small-bore wire-guided thoracostomy tube placement in cats-a cadaver study.
BMC Vet Res
October 2024
Tierarztpraxis am Stadtpark GmbH, Reisnerstrasse 7/1, Vienna, A-1030, Austria.
Article Synopsis
- The study investigates the relationship between the position of cats during the insertion of small-bore wire-guided thoracostomy tubes (SBWGTT) and the occurrence of complications, focusing on risks associated with different placement methods.
- Conducted on 24 feline cadavers split into two groups (pleural effusion and pneumothorax), the study reveals that complications occur more frequently when cats are not in the ideal recumbent position for their specific condition.
- A total of 48 SBWGTTs were inserted, with a complication rate of 33.3%, where most major complications (such as lung lacerations) occurred during unfavorable positioning, indicating a potential risk factor that needs further statistical validation.