Extended-FAST plus MDCT in pneumothorax diagnosis of major trauma: time to revisit ATLS imaging approach?

ConclusionOur results demonstrate that bedside thoracic US is characterized by a very good accuracy in the diagnostic work-up of major trauma patients, even in difficult conditions, allowing rapid diagnosis of PNX.Advances in knowledgeThe novelty of this research lies in the possibility of diagnosing potential life-threatening conditions in a very short time by means of US, thus proposing a revision of the Advanced Trauma Life Support (ATLS) guidelines in order to incorporate it in the work-up of high-energy injured patients.
Source: Journal of Ultrasound - Category: Radiology Source Type: research

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AbstractPurposeTo assess the efficacy of the tract embolization technique using gelatin sponge slurry after CT-guided lung biopsy to reduce pneumothorax and chest tube placement rates.Materials and MethodsWe retrospectively compared 231 CT-guided lung biopsies performed with the tract embolization technique using gelatin sponge slurry (treated group) with 213 biopsies performed without embolization (control group). All procedures were performed at our institution between January 2014 and September 2018 by one of three experienced interventional radiologists using a 19-gauge coaxial needle. Multivariate analysis was perform...
Source: CardioVascular and Interventional Radiology - Category: Radiology Source Type: research
Introduction: Pleural effusion is considered the most common presentation of pleural diseases; around 50% of cases of pleural effusion remain undiagnosed following thoracentesis.Purpose: To compare between the diagnostic accuracy, safety and complications of medical thoracoscopic (MT) versus CT guided (CTG) tru-cut pleural biopsy.Patients and Methods: The patients with unexplained exudative pleural effusion were classified into two groups for either MT or CTG tru-cut pleural biopsy. The pleural biopsies obtained during both procedures were sent for mycobacterial culture and histopathology.Results: Complications of MT were ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pleural and mediastinal malignancies Source Type: research
Conclusions: Ambulatory pneumothorax management is safe and can be established with clear local protocols in place. Large UK based trials in primary and secondary pneumothoraces are ongoing.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
Conclusion: In this first in human study the 5.5LP EBV was feasible and could be placed into wide segments with a shorter landing space without complications and with good efficacy outcomes.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
Conclusions: Preventive therapies are routinely performed after the procedure, but a common consensus is needed to define risk factors, prevent and manage the complications. In addition, we think that it would be more beneficial to use the percentages as per procedures or per patients in the identification of complications.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
Introduction: Post-procedural pneumothorax (PNT) is one of the most frequently reported side-effects occurring after endobronchial valve placement for lung volume reduction (10-35%). We wondered if a more progressive volume reduction with the sequential implantations of valves in 2 sessions would reduce this rate.Method: Emphysema patients were selected for fissure integrity, hyperinflation and lobe volume using quantitative CT (StratX, Pulmonx Inc) and plethysmography assessments. A physiological absence of collateral ventilation was confirmed by Chartis measurements (Chartis, Pulmonx Inc) before treatment. Lobar occlusio...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
Conclusions: SPM should be considered in the differential diagnosis of acute chest pain in adolescents. Asthma patients may necessitate prolonged hospital stay and require careful surveillance, eliminating complications that may influence outcome.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric respiratory epidemiology Source Type: research
We report on the 6 &12-month results of the AATD arm of the EMPROVE study.20 AATD subjects on optimal medical management with hyperinflation, severe dyspnea were treated with SVS valves at 12 centers. Target lobe selection was done using high resolution computed tomography. Targeted lobe was a lower lobe in 85% and an upper lobe in 15% of patients.A mean of 4.4 valves per patient were used to isolate the target lobe, with an average procedure time of 20 minutes. Results are presented as baseline and mean changes in FEV1, Target Lobe Volume (TLV), disease specific quality of life measures – St. George’s Resp...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
Conclusions: ELVR with the 9mm IBV valves was associated with a modest but sustained improvement of FEV1, mMRC and 6MWT up to 6 months post-intervention. The incidence of pneumothoraxes requiring drainage was 26.5%.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
Conclusion: CT based DSS seems to predict need for early surgery and recurrence after first episode of PSP. CT can be used to risk stratify PSP patients and identify those at risk of failure of conventional treatment and early recurrence. Smoking status appears to have a link with high grade DSS. Further prospective randomized studies are needed to validate these findings.Table 1.Dystrophy Severity Score (DSS) adapted from World J Surg. 2016;40(5):1112-20CT verified air-containing lesions0 point1 point2 pointsTypeNilBlebs (1cm)NumberNilSingleMultipleDistributionNilUnilateralBilateral
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Imaging Source Type: research
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