Pneumothorax Research Papers - Academia.edu (original) (raw)

Respiratory mechanics, chest wall configuration, and lung morphometry were determined in rats before and at 30 (PTX.30) and 60 (PTX.60) min after pneumothorax induction (intrathoracic injection of 8 ml of room air; 50% collapse).... more

Respiratory mechanics, chest wall configuration, and lung morphometry were determined in rats before and at 30 (PTX.30) and 60 (PTX.60) min after pneumothorax induction (intrathoracic injection of 8 ml of room air; 50% collapse). Pneumothorax increased respiratory system and lung elastances and viscoelastic/inhomogeneous pressures in both groups, but respiratory system and lung resistive pressures increased only in PTX.60 group. Antero-posterior diameters at the third intercostal space and xiphoid levels, circumference at xiphoid level, and thoracic cephalo-caudal diameter increased significantly after pneumothorax induction independently of temporal evolution. In both groups lung collapse, hyperinflation, and interstitial and alveolar edema were present. Additionally, in PTX.60 group the central airways calibre diminished in relation to PTX.30. In conclusion pneumothorax yields changes in respiratory system and lung elastic and viscoelastic parameters, which are related to alveolar collapse and edema, respectively. Temporal evolution of pneumothorax also leads to changes in lung resistive pressure, probably because of airway narrowing.

Myofascial pain syndrome is defined as ``pain and/or autonomic phenomena referred from active myofascial trigger points''. Trigger point injection is an effective treatment option, which is widely used to treat myofascial pain.... more

Myofascial pain syndrome is defined as ``pain and/or autonomic phenomena referred from active myofascial trigger points''. Trigger point injection is an effective treatment option, which is widely used to treat myofascial pain. Trigger point injection in the cervicothoracic regions can be associated with pneumothorax. In this paper, we presented a patient who developed pneumothorax after trigger point injection. This case report indicates there is a risk of pneumothorax during trigger point injection in the cervicothoracic regions.

Background: Traumatic hemothorax and pneumothorax are common injuries for which conventional treatment is large bore chest tube placement. Increasingly, small bore pigtail catheters are used to treat non-traumatic pneumothorax and pleural... more

Background: Traumatic hemothorax and pneumothorax are common injuries for which conventional treatment is large bore
chest tube placement. Increasingly, small bore pigtail catheters are used to treat non-traumatic pneumothorax and pleural effusions, however they have not been widely adopted for trauma. The objective of this systematic review is to examine the evidence
behind pigtail catheter use in traumatic and iatrogenic hemothorax and pneumothorax.
Methods: We searched PubMed and Embase databases and selected all studies that examined the use of pigtail catheters in
traumatic or iatrogenic hemothorax or pneumothorax. Pediatric studies were excluded. We evaluated the quality of each study
using GRADE criteria. A meta-analysis was completed to compare the success rate of pigtail catheter placement for traumatic
or iatrogenic pneumothoraces. Many of the studies did not have a comparison group rendering the data insufficient to analyze
chest tube success rates. Data on other endpoints were too heterogeneous to synthesize quantitatively.
Results: We identified two studies of pigtail catheter use in traumatic hemothorax, two studies in traumatic pneumothorax, and
four studies in iatrogenic pneumothorax. Success rates with a pigtail catheter ranged from 92% to 100% for traumatic hemothorax, 89% to 95% for traumatic pneumothorax, and 71% to 88% for iatrogenic pneumothorax. Our meta-analysis yielded a
pooled success rate of 85% for pigtail catheters treating iatrogenic and traumatic pneumothorax.traumatic and iatrogenic hemothorax and pneumothorax.

Pneumothorax (Ptx) is a life-threatening complication that can result from trauma, mechanical ventilation, and invasive procedures. Infrared thermography (IRT), a compact and portable technology, has become highly sensitive. We... more

Pneumothorax (Ptx) is a life-threatening complication that can result from trauma, mechanical ventilation, and invasive procedures. Infrared thermography (IRT), a compact and portable technology, has become highly sensitive. We hypothesized that IRT could detect Ptx by identifying associated changes in skin temperature.Bilateral nonpenetrating chest incisions or needle punctures were performed in 21 anesthetized rats. Rats were then randomized to no, bilateral, left, or right Ptx by either open (n = 16) or closed percutaneous (n = 5) puncture through selected pleurae. Real-time thermographic images and surface temperature data were acquired with a noncooled infrared camera.In all cases, blinded observers correctly identified each Ptx with real-time grayscale image analysis. When compared to either the ipsilateral baseline or an abdominal reference, experimental Ptx produced a significantly greater decrease in surface temperature when compared to non-Ptx control.These results demonstrate that portable infrared imaging can rapidly and accurately detect changes in thoracic surface temperature associated with experimental pneumothorax.

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The incorrect insertion of a chest drain can cause serious harm or even death. All elective drains should be inserted in the... more

The incorrect insertion of a chest drain can cause serious harm or even death. All elective drains should be inserted in the 'triangle of safety' in line with the British Thoracic Society guidelines. The aim of this study was to test the awareness of junior doctors involved in inserting chest drains with these guidelines. Fifty junior doctors were questioned. Participants were asked to grade their experience of chest drain insertion and mark on a diagram where they felt was the optimum site for inserting a drain for a large pneumothorax in an elective situation. Only 44% (n=22) of doctors indicated they would insert a chest drain within the safe triangle. Level of experience, seniority and specialty all had an effect on knowledge of the correct site. Of those who had inserted drains unsupervised, 48% (n=16) would site the drain outside the safe triangle as would 75% (n=6) of those who had performed the procedure supervised. Only 25% of medics knew where to insert a drain, compared with 58% of doctors working in surgery. The majority of junior doctors do not have the basic knowledge to insert a chest drain safely. Further training in this procedure is needed for junior doctors.

To examine rates, trends, predictive risk factors, and outcomes associated with pneumothorax in neonates. Retrospective analyses were used to estimate rates and assess trends in pneumothorax among early preterm (GA <32 weeks),... more

To examine rates, trends, predictive risk factors, and outcomes associated with pneumothorax in neonates. Retrospective analyses were used to estimate rates and assess trends in pneumothorax among early preterm (GA <32 weeks), moderate-late preterm (GA 32-36), and term (GA ≥37 weeks) neonates admitted to neonatal intensive care units (NICUs) participating in the Canadian Neonatal Network™ from 2005 to 2011. For each GA group, multivariable logistic regression models were derived to predict pneumothorax using risk factors with known clinical relevance. Additional logistic regression analyses assessed associations between pneumothorax and mortality, bronchopulmonary dysplasia, and intraventricular hemorrhage. The study included 71,237 neonates; of them 16,985 (24%) early preterm, 27,709 (39%) moderate-late preterm, and 26,543 (37%) term neonates. The overall rate of pneumothorax by GA was bimodal with estimates of 4.0%, 2.6%, and 6.7% respectively. No significant temporal trends we...

During the recent United States Central Command (USCENTCOM) and Joint Trauma System (JTS) assessment of prehospital trauma care in Afghanistan, the deployed director of the Joint Theater Trauma System (JTTS), CAPT Donald R. Bennett,... more

During the recent United States Central Command (USCENTCOM) and Joint Trauma System (JTS) assessment of prehospital trauma care in Afghanistan, the deployed director of the Joint Theater Trauma System (JTTS), CAPT Donald R. Bennett, questioned why TCCC recommends treating a nonlethal injury (open pneumothorax) with an intervention (a nonvented chest seal) that could produce a lethal condition (tension pneumothorax). New research from the U.S. Army Institute of Surgical Research (USAISR) has found that, in a model of open pneumothorax treated with a chest seal in which increments of air were added to the pleural space to simulate an air leak from an injured lung, use of a vented chest seal prevented the subsequent development of a tension pneumothorax, whereas use of a nonvented chest seal did not. The updated TCCC Guideline for the battlefield management of open pneumothorax is: ?All open and/ or sucking chest wounds should be treated by immediately applying a vented chest seal to c...

This is the second report based on a survey of Divers Alert Network Asia-Pacific (DAN AP) members who dive with cardiovascular and respiratory conditions and diabetes. It examines the medical management of the divers' conditions, any... more

This is the second report based on a survey of Divers Alert Network Asia-Pacific (DAN AP) members who dive with cardiovascular and respiratory conditions and diabetes. It examines the medical management of the divers' conditions, any diving modifications used to mitigate the risk and outcomes. An online cross-sectional survey was sent to 833 divers who had declared a targeted medical condition when applying for DAN AP membership between July 2009 and August 2013. Two-hundred-and-sixty-eight respondents (32%) provided sufficient information on their conditions to be included in the analyses. These included ischaemic heart disease (31), arrhythmias (20), cardiac septal defects (31), other cardiac conditions (10), hypertension (127), diabetes (25), asthma (40) and pneumothorax (5). Forty-nine per cent had sought specialist diving medical advice about their condition and 23% reported modifying their diving practices to mitigate their risk. The cohort had completed 183,069 career div...

Safe and reliable venous access is mandatory in modern health care, but central venous catheters (CVCs) are associated with significant morbidity and mortality, This paper describes current Swedish guidelines for clinical management of... more

Safe and reliable venous access is mandatory in modern health care, but central venous catheters (CVCs) are associated with significant morbidity and mortality, This paper describes current Swedish guidelines for clinical management of CVCs The guidelines supply updated recommendations that may be useful in other countries as well. Literature retrieval in the Cochrane and Pubmed databases, of papers written in English or Swedish and pertaining to CVC management, was done by members of a task force of the Swedish Society of Anaesthesiology and Intensive Care Medicine. Consensus meetings were held throughout the review process to allow all parts of the guidelines to be embraced by all contributors. All of the content was carefully scored according to criteria by the Oxford Centre for Evidence-Based Medicine. We aimed at producing useful and reliable guidelines on bleeding diathesis, vascular approach, ultrasonic guidance, catheter tip positioning, prevention and management of associated trauma and infection, and specific training and follow-up. A structured patient history focused on bleeding should be taken prior to insertion of a CVCs. The right internal jugular vein should primarily be chosen for insertion of a wide-bore CVC. Catheter tip positioning in the right atrium or lower third of the superior caval vein should be verified for long-term use. Ultrasonic guidance should be used for catheterisation by the internal jugular or femoral veins and may also be used for insertion via the subclavian veins or the veins of the upper limb. The operator inserting a CVC should wear cap, mask, and sterile gown and gloves. For long-term intravenous access, tunnelled CVC or subcutaneous venous ports are preferred. Intravenous position of the catheter tip should be verified by clinical or radiological methods after insertion and before each use. Simulator-assisted training of CVC insertion should precede bedside training in patients. Units inserting and managing CVC should have quality assertion programmes for implementation and follow-up of routines, teaching, training and clinical outcome. Clinical guidelines on a wide range of relevant topics have been introduced, based on extensive literature retrieval, to facilitate effective and safe management of CVCs.

Coronavirus disease 19 (COVID-19) caused by SARS-CoV-2 has spread worldwide resulting in ongoing pandemic. Lung is the most common organ involved in COVID-19 with common radiological finding being ground glass opacities in peripheral... more

Coronavirus disease 19 (COVID-19) caused by SARS-CoV-2 has spread worldwide resulting in ongoing pandemic. Lung is the most common organ involved in COVID-19 with common radiological finding being ground glass opacities in peripheral distribution and lower lobes. 1 Pneumothorax is uncommon feature to observe with COVID-19. The exact incidence of this complication is still not known. In a report by Chen et al. 1% (one patient) had a pneumothorax among other radiographic features. 2 In a study published by Yang and colleagues in 92 deceased COVID-19 patients, one (1.1%) had a pneumothorax. 3 The mechanism of spontaneous pneumothorax in patients with COVID19 disease is proposed to be related to the structural changes in the lung parenchyma which include cystic and fibrotic changes leading to alveolar tears. In addition to the increase in intrathoracic pressure resulting from prolonged coughing and/or mechanical ventilation. 4,5 Pneumothorax further complicates the case of COVID-19. We ...

Background; Drowning is defined as respiratory impairment due to submersion/immersion in liquid. The liquid/air interface at the entrance of the airway prevents the victim from breathing air. According to the World Health Organization... more

Background; Drowning is defined as respiratory impairment due to submersion/immersion in liquid. The liquid/air interface at the entrance of the airway prevents the victim from breathing air. According to the World Health Organization (WHO), 0.7% of all deaths worldwide – or more than 500,000 deaths each year – are due to unintentional drowning. Drowning is the second leading cause of unnatural death after road traffic injuries. Most of these deaths occur in countries with low or middle per capita income. Case; A16-years-old man rescued after drowning in the mud puddle for 15 minutes. He was unconscious, cyanosis, dyspnea and cough with blood and mud. After receiving oxygen in the nearest hospital he got conscious but still dyspnea. He came to our hospital and after undergone several examination we concluded that he had lung edema, ARDS and pneumonia aspiration. Patient immediately intubated and got mechanical ventilation. Five days later patient encounter pneumothorax on the right hemithorax, maybe due to barotrauma and we perfomed a chet tube insertion for three days. Patient had a good progression, there was no deficit neurologic and injury in the other organ. On follow up five months after patient hospitalized revealed normal condition on chest x ray.