Thoracostomy
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EACTS expert consensus statement for surgical management of pleural empyema Open
Pleural infection is a frequent clinical condition. Prompt treatment has been shown to reduce hospital costs, morbidity and mortality. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews…
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Hemothorax: A Review of the Literature Open
Hemothorax is a collection of blood in the pleural cavity usually from traumatic injury. Chest X-ray has historically been the imaging modality of choice upon arrival to the hospital. The sensitivity and specificity of point-of-care ultras…
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Using an incentive spirometer reduces pulmonary complications in patients with traumatic rib fractures: a randomized controlled trial Open
Background An incentive spirometer (IS) is a mechanical device that promotes lung expansion. It is commonly used to prevent postoperative lung atelectasis and decrease pulmonary complications after cardiac, lung, or abdominal surgery. This…
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Complications in tube thoracostomy: Systematic review and meta-analysis Open
BACKGROUND Tube thoracostomy (TT) complications and their reported rates are highly variable (1–40%) and inconsistently classified. Consistent TT complication classification must be applied to compare reported literature to standardize TT …
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Association Between Adherence to Evidence-Based Practices for Treatment of Patients With Traumatic Rib Fractures and Mortality Rates Among US Trauma Centers Open
Significant variation appears to exist in the delivery of EBPs for rib fractures across US trauma centers. Three EBPs were associated with reduced mortality, but EBP adherence was poor. Multiple factors, including trauma center verificatio…
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Recurrence of primary spontaneous pneumothorax in young adults and children Open
In the present study, postoperative recurrence rates were higher than those in the literature. Intense and long-term follow-up was probably one reason for the relatively high recurrence rate. The recurrence rate after wedge resection in pa…
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Tube thoracostomy during the COVID-19 pandemic: guidance and recommendations from the AAST Acute Care Surgery and Critical Care Committees Open
This document provides guidance for trauma and acute care surgeons surrounding the placement, management and removal of chest tubes during the COVID-19 pandemic.
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Comprehensive Review of Chest Tube Management Open
Chest tube management is subjective, but the compilation of data can inform best practices and safe application to successfully manage the pleural space and ameliorate acquired pleural space disease.
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Needle thoracostomy Open
Therapeutic study, level IV.
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Video-assisted thoracoscopic decortication for the management of late stage pleural empyema, is it feasible? Open
VATSD facilitates the management of fibrinopurulent, organized pyogenic pleural empyema with less postoperative discomfort, reduced hospitalization, and have fewer postoperative complications. VATSD can be an effective, safe first option f…
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Potential benefit of early operative utilization of low profile, partial resuscitative endovascular balloon occlusion of the aorta (P-REBOA) in major traumatic hemorrhage Open
A 28-year-old man with multiple gunshot wounds to the chest and upper extremities was transported by private vehicle to a community hospital with limited trauma capabilities. On arrival he developed pulseless electrical activity and cardio…
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Evaluation of Gunshot Wounds in the Emergency Department Open
Mortality rates in gunshot wound patients with cranial injuries are very high. Spontaneous return is not seen in patients brought to the ED in arrest state. Bullets can cause internal organ injuries which can be greater than expected. In t…
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Determining optimal fluid and air leak cut off values for chest drain management in general thoracic surgery. Open
Our results show that chest drains can be safely removed without fluid criteria and air leak of less than 20 mL/min with median drain duration of 1 day, associated with a reduced length of hospital stay.
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Management of extensive surgical emphysema with subcutaneous drain: A case report Open
In the absence of a comparative study to identify the most effective method to manage extensive subcutaneous emphysema, this case highlights an effective, simple and safe management option.
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When size matters: changing opinion in the management of pleural space—the rise of small-bore pleural catheters Open
Tube thoracostomy is usually the first step to treat several thoracic/pleural conditions such as pneumothorax, pleural effusions, haemothorax, haemo-pneumothorax and empyema. Today, a wide range of drains is available, ranging from small t…
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Finger thoracostomy in patients with chest trauma performed by paramedics on a helicopter emergency medical service Open
Objective To determine the frequency of finger thoracostomy performed by intensive care flight paramedics after the introduction of a training programme in this procedure and complications of the procedure that were diagnosed after hospita…
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Prehospital portable ultrasound for safe and accurate prehospital needle thoracostomy: a pilot educational study Open
Background Simulated needle thoracostomy (NT) using ultrasound may reduce potential injury, increase accuracy, and be as rapid to perform as the traditional landmark technique following a brief educational session. Our objective was to det…
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Mini-open vacuum-assisted closure therapy with instillation for debilitated and septic patients with pleural empyema Open
Mini-VAC-Instill therapy is an upgrade of Mini-VAC, which guarantees the advantage of an open treatment, including flushing but without OWT. This procedure is minimally invasive, highly compatible especially with patients in poor general c…
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Needle thoracostomy for tension pneumothorax: the Israeli Defense Forces experience Open
Standard NT has a high failure rate on the battlefield. Alternative measures for chest decompression, such as the Vygon catheter, appear to be a feasible alternative to conventional NT.
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Occult Pneumothorax in Patients Presenting with Blunt Chest Trauma: An Observational Analysis Open
Background: We aimed to assess the management and outcome of occult pneumothorax and to determine the factors associated with failure of observational management in patients with blunt chest trauma (BCT). Methods: Patients with BCT were re…
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Serratus Anterior Plane Block in the Emergency Department: A Case Series Open
This is a case series of six emergency department (ED) patients who received an ultrasound-guided serratus anterior plane block (SAPB) for a variety of painful conditions. Our cases illustrate the feasibility and analgesic efficacy of the …
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Pneumothorax in patients with respiratory failure in ICU Open
Pneumothorax is not an uncommon occurrence in ICU patients. Barotrauma and iatrogenesis remain the most common causes for pneumothorax in critically ill patients. Patients with underlying lung disease are more prone to develop pneumothorax…
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A Prospective Randomized Trial Comparing Manual Needle Aspiration to Closed Thoracostomy as an Initial Treatment for the First Episode of Primary Spontaneous Pneumothorax Open
Needle aspiration is a favorable initial treatment in patients experiencing a first episode of PSP.
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The Efficacy of VATS and Intrapleural Fibrinolytic Therapy in Parapneumonic Empyema Treatment Open
It was demonstrated that both of the methods applied in the study have high efficacy and are preferable methods based on the general conditions of patients. Additionally, the shorter length of hospital stays in patients received VATS-D was…
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Short-term and long-term outcomes of intrathoracic vacuum therapy of empyema in debilitated patients Open
For debilitated patients, immediate minimally invasive intrathoracic vacuum therapy is a safe and viable alternative to OWT. Mini-VAC-Instill may have the fastest clearance and healing rates of empyema.
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Association of Prehospital Needle Decompression With Mortality Among Injured Patients Requiring Emergency Chest Decompression Open
Importance Prehospital needle decompression (PHND) is a rare but potentially life-saving procedure. Prior studies on chest decompression in trauma patients have been small, limited to single institutions or emergency medical services (EMS)…
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Adenovirus Pneumonia Complicated With Acute Respiratory Distress Syndrome Open
Severe adenovirus infection in children can manifest with acute respiratory distress syndrome (ARDS) and respiratory failure, leading to the need for prolonged mechanical support in the form of either mechanical ventilation or extracorpore…
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Diagnosis and Management of Malignant Pleural Effusion: A Decade in Review Open
Malignant pleural effusion (MPE) is a common complication of thoracic and extrathoracic malignancies and is associated with high mortality. Treatment is mainly palliative, with symptomatic management achieved via effusion drainage and pleu…
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Delayed massive hemothorax requiring surgery after blunt thoracic trauma over a 5-year period: complicating rib fracture with sharp edge associated with diaphragm injury Open
Delayed massive hemothorax requiring surgery is relatively uncommon and can potentially be life-threatening. Here, we aimed to describe the nature and cause of delayed massive hemothorax requiring immediate surgery. Over 5 years, 1,278 con…
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Management of computed tomography-detected pneumothorax in patients with blunt trauma: experience from a community-based hospital Open
Chest tube was inserted in less than half of the patients with blunt trauma for whom pneumothorax was detected on CT. Pneumothorax volume should be considered in decision-making regarding chest tube insertion. Conservative treatment may be…