Iatrogenic Pneumopericardium after tube thoracostomy: A Case Report
Publication date: Available online 8 October 2020Source: International Journal of Surgery Case ReportsAuthor(s): Esubalew Taddese Mindaye, Abraham Arayia, Tesfaye H. Tufa, Mahteme Bekele (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - October 9, 2020 Category: Surgery Source Type: research

Pre-Hospital Simple Thoracostomy Does Not Improve Patient Outcomes Compared to Needle Thoracostomy in Severely Injured Trauma Patients
WITHDRAWN (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 30, 2020 Category: Surgery Authors: Charles Harris, Sharven Taghavi, Juan Duchesne, Tomas Jacome, Danielle Tatum Tags: Trauma Source Type: research

Trauma Tube Thoracostomy is Associated with Increased Risk of Posttraumatic Empyema in Geriatric Patients
Posttraumatic empyema has been associated with worse clinical outcomes. We investigated the impact of age on the incidence and outcomes in patients who sustained chest injury and were diagnosed with empyema. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 30, 2020 Category: Surgery Authors: Christina Xinyue Zhang, Melissa Canas, Louisa Bai, Esha Ghosh, Ricardo A. Fonseca, Jose A. Aldana, Rohit R. Rasane, Javier Rincon, Jennifer M. leonard, Grant V. Bochicchio Tags: Trauma Source Type: research

Predictors of retained hemothorax in trauma: Results of an Eastern Association for the Surgery of Trauma multi-institutional trial
BACKGROUND The natural history of traumatic hemothorax (HTX) remains unclear. We aimed to describe outcomes of HTX following tube thoracostomy drainage and to delineate factors that predict progression to a retained hemothorax (RH). We hypothesized that initial large-volume HTX predicts the development of an RH. METHODS We conducted a prospective, observational, multi-institutional study of adult trauma patients diagnosed with an HTX identified on computed tomography (CT) scan with volumes calculated at time of diagnosis. All patients were managed with tube thoracostomy drainage within 24 hours of presentation. Retain...
Source: Journal of Trauma and Acute Care Surgery - September 29, 2020 Category: Surgery Tags: 2019 EAST PODIUM PAPER Source Type: research

Effectiveness and safety of small-bore tube thoracostomy ( ≤20 Fr) for chest trauma patients: A retrospective observational study
Tube thoracostomy is an important treatment for traumatic hemothorax and pneumothorax. The optimal tube diameter remains unclear. To reduce invasiveness, we use small-bore chest tubes ( ≤20 Fr) for all trauma patients for whom tube thoracostomy is indicated in our emergency department (ED). The aim of this study was to investigate the effectiveness and safety of small-bore tube thoracostomy for traumatic hemothorax or pneumothorax. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - September 14, 2020 Category: Emergency Medicine Authors: Toshinori Maezawa, Machi Yanai, Ji Young Huh, Koichi Ariyoshi Source Type: research

Resident perception of standardization and credentialing for high ‐risk bedside procedures in cardiothoracic surgery: Results from an institutional pilot study
ConclusionCardiothoracic residents have favorable attitudes towards standardization and credentialing for high ‐risk bedside procedures and utilizing such courses may help standardize procedural techniques. (Source: Journal of Cardiac Surgery)
Source: Journal of Cardiac Surgery - September 8, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Olugbenga Okusanya, Alexandrea Bartow, Edgar Aranda ‐Michel, Angela Kinnunen, Matthew Schuchert, Arman Kilic, Pablo Sanchez, Rajeev Dhupar, James Luketich, Ibrahim Sultan Tags: ORIGINAL ARTICLE Source Type: research

“Decompression of tension pneumothorax in a trauma patient –first use of a novel decompression colorimetric capnography device in human patient”
We report a case of 58-year-old male treated by EMS following a motorcycle accident with left-sided chest pain, hypoxia, hypotension, and clinical findings of tension pneumothorax. Needle decompression with colorimetric capnography using the device indicated decompression of his tension pneumothorax, with appropriate temporizing success. (Source: General Thoracic and Cardiovascular Surgery)
Source: General Thoracic and Cardiovascular Surgery - September 2, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Robotic Bronchoscopy for Peripheral Pulmonary Lesions: A Multicenter Pilot and Feasibility Study (BENEFIT).
Abstract BACKGROUND: The diagnosis of peripheral pulmonary lesions (PPL) continues to present clinical challenges. Despite extensive experience with guided bronchoscopy, the diagnostic yield has not significantly improved. Robotic assisted bronchoscopic platforms have been developed to potentially improve the diagnostic yield for PPL. Presently, limited data exists evaluating the performance of robotic systems in live human subjects. RESEARCH QUESTION: What is the safety and feasibility of robotic assisted bronchoscopy in patients with peripheral pulmonary lesions? STUDY DESIGN AND METHODS: This was a pr...
Source: Chest - August 17, 2020 Category: Respiratory Medicine Authors: Chen AC, Pastis NJ, Mahajan AK, Khandhar SJ, Simoff MJ, Machuzak MS, Cicenia J, Gildea TR, Silvestri GA Tags: Chest Source Type: research

A Comparison of Prehospital Nonphysician and Hospital Physician Placed Tube Thoracostomy.
This report is one of the first to compare demographics and outcomes in patients undergoing prehospital chest decompression by trained aeromedical nonphysician personnel to hospital chest decompression by physicians. METHODS: Prehospital tube thoracostomy (PTT) patients were identified from January 2014 to January 2019 and were matched in a 1:2 ratio based on age, Injury Severity Score (ISS), and chest Abbreviated Injury Score (AIS) to patients who underwent hospital tube thoracostomy (HTT) within 24 hours of admission. RESULTS: Forty-nine PTT patients were matched to 98 HTT patients. PTT patients had lower admis...
Source: The American Surgeon - July 27, 2020 Category: Surgery Authors: Harrell KN, Brooks DE, Palm PH, Cowart JT, Maxwell R, Barker D Tags: Am Surg Source Type: research

Is a Chest Radiograph After Thoracostomy Tube Removal Necessary? A Cost-Effective Analysis
Worldwide traumatic injury costs an estimated $518 billion [1]. With thoracic injury occurring in approximately 60% of polytrauma patients [2] and penetrating thoracic injuries accounting for up to 13% of trauma admissions [3], thoracic injury represents a significant economic impact on the healthcare system. Pneumothorax (PTX) and hemothorax (HTX) are common pathologies in thoracic trauma patients. The placement of a thoracostomy tube (TT) to evacuate the chest following these injuries has been used since World War II and the Korean war [4], remaining the standard of care for evacuation and initial management of most trau...
Source: Injury - July 25, 2020 Category: Orthopaedics Authors: Genna Beattie, Caitlin M. Cohan, Kathryn Chomsky-Higgins, Annie Tang, Lara Senekjian, Gregory P. Victorino Source Type: research

Re-Expansion Pulmonary Edema After Thoracostomy
A 40-year-old female patient was transferred to our emergency department with a suspected left-sided pneumothorax as an incidental finding during a health examination. On clinical examination, her vital signs were normal with no signs of desaturation. Physical examination revealed tympanic percussion and decreased breath sounds over the left hemithorax. Chest radiography showed left-sided pneumothorax with complete collapse of the lung (Figure  1). A pigtail catheter was inserted and connected to water seal drainage system without additional suction pressure. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - July 24, 2020 Category: Emergency Medicine Authors: Jen-Hao Nieh, Tai-Yu Huang Tags: Visual Diagnosis in Emergency Medicine Source Type: research

Chest ultrasonography versus supine chest radiography for diagnosis of pneumothorax in trauma patients in the emergency department.
Abstract BACKGROUND: Chest X-ray (CXR) is a longstanding method for the diagnosis of pneumothorax but chest ultrasonography (CUS) may be a safer, more rapid, and more accurate modality in trauma patients at the bedside that does not expose the patient to ionizing radiation. This may lead to improved and expedited management of traumatic pneumothorax and improved patient safety and clinical outcomes. OBJECTIVES: To compare the diagnostic accuracy of chest ultrasonography (CUS) by frontline non-radiologist physicians versus chest X-ray (CXR) for diagnosis of pneumothorax in trauma patients in the emergency depa...
Source: Cochrane Database of Systematic Reviews - July 22, 2020 Category: General Medicine Authors: Chan KK, Joo DA, McRae AD, Takwoingi Y, Premji ZA, Lang E, Wakai A Tags: Cochrane Database Syst Rev Source Type: research

A very rare fatal complication: bilateral reexpansion pulmonary edema after treatment of single side total pneumothothorax.
ğun İG, Balcı A Abstract Reexpansion pulmonary edema is a rare but fatal clinical condition that develops during the treatment of pneumothorax, pleural effusion and collapsed lung after atelectasis. A 31-year-old male patient was referred to our clinic with the complaint of stinging back pain that started 3 days ago and dyspnea developed during the last 24 hours. Physical examination and radiologic examinations revealed total pneumothorax in the right hemithorax. After tube thoracostomy, his general condition deteriorated and bilateral reexpension edema developed in the lungs. The patient was admitted to the i...
Source: Tuberkuloz ve Toraks - June 30, 2020 Category: Respiratory Medicine Authors: Dumanlı A, Günay E, Öz G, Aydın S, Çilekar Ş, Gencer A, Çoşğun İG, Balcı A Tags: Tuberk Toraks Source Type: research

Safe chest tube placement in a patient with tension pneumothorax receiving rivaroxaban therapy for non-valvular atrial fibrillation.
This report describes a case in which emergency placement of a tube thoracostomy, in a patient with type 2 respiratory failure due to left tension pneumothorax and receiving the anticoagulant rivaroxaban, in the pharmacokinetics phase with greater anticoagulant effect, did not result in bleeding greater than that typically encountered during such interventions. The procedure ended successfully with no acute complications. PMID: 32548992 [PubMed - in process] (Source: Monaldi Archives for Chest Disease)
Source: Monaldi Archives for Chest Disease - June 19, 2020 Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research

Concealment of trauma and occupational accidents among Fukushima nuclear disaster decontamination workers: A case report.
CONCLUSION: Trauma or physical injury of any kind is an occupational hazard for workers, especially those operating in the chaotic and unpredictable environments following any disasters. Companies employing such workers and owners of any facilities or locations in which they may be working are responsible for the safety of their workers. They should provide appropriate training and should comply with all prevailing Employment Laws and follow mandatory safety regulations. If companies and authorities are in breach of any laws, ignore their responsibilities, or jeopardize the health of their workers, they should be held acco...
Source: Journal of Occupational Health - June 11, 2020 Category: Occupational Health Tags: J Occup Health Source Type: research

Safety of the anterior approach versus the lateral approach for chest tube insertion by residents treating spontaneous pneumothorax: a propensity score weighted analysis
ConclusionsThe current study revealed that the risk of chest tube malposition in thoracostomies with the midclavicular approach was not different from that with the lateral approach. (Source: General Thoracic and Cardiovascular Surgery)
Source: General Thoracic and Cardiovascular Surgery - June 8, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

The effects of analgesic treatment and chest physiotherapy on the complications of the patients with rib fractures that arise from blunt chest trauma.
Abstract BACKGROUND: This prospective study aims to investigate the effect of chest physiotherapy and analgesic therapy on the possible complications of isolated rib fractures attributable to blunt thoracic trauma, such as hemothorax and pneumothorax. METHODS: Patients who presented to Çanakkale Onsekiz Mart University School of Medicine Hospital's Emergency Department and Thoracic Surgery outpatient clinics within the first 24 hours of the post-traumatic period and did not have additional intrathoracic complications at presentation with blunt thoracic trauma and who were diagnosed with isolated rib fr...
Source: Turkish Journal of Trauma and Emergency Surgery : TJTES - May 31, 2020 Category: Emergency Medicine Authors: Alar T, Gedik İE, Kara M Tags: Ulus Travma Acil Cerrahi Derg Source Type: research

Complications from Needle Thoracostomy: Penetration of the Myocardium.
We report a rare but serious complication of needle thoracostomy, penetration of the myocardium. Needle thoracostomy is typically performed in the prehospital setting or upon arrival in the emergency department for suspected tension pneumothorax. Needle decompression is generally taught and done anteriorly, in the 2nd intercostal space on the midclavicular line (MCL). An alternative approach is laterally, along the anterior axillary line (AAL) in the 4th intercostal space. Our case supports prior literature that the anterior MCL location has a low rate of efficacy to decompress the chest, as well as a high rate of complica...
Source: Prehospital Emergency Care - May 23, 2020 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Management of Complications After Lung Resection
Prolonged air leak or alveolar-pleural fistula is common after lung resection and can usually be managed with continued pleural drainage until resolution. Further management options include blood patch administration, chemical pleurodesis, and 1-way endobronchial valve placement. Bronchopleural fistula is rare but is associated with high mortality, often caused by development of concomitant empyema. Bronchopleural fistula should be confirmed with bronchoscopy, which may allow bronchoscopic intervention; however, transthoracic stump revision or window thoracostomy may be required. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - April 16, 2020 Category: Cardiovascular & Thoracic Surgery Authors: James M. Clark, David T. Cooke, Lisa M. Brown Source Type: research

Management of Complications after Lung Resection: Prolonged Air Leak and Bronchopleural Fistula
Prolonged air leak or alveolar-pleural fistula is common after lung resection and can usually be managed with continued pleural drainage until resolution. Further management options include blood patch administration, chemical pleurodesis, and one-way endobronchial valve placement. Bronchopleural fistula is rare but is associated with high mortality, often due to development of concomitant empyema. Bronchopleural fistula should be confirmed with bronchoscopy, which may allow for bronchoscopic intervention; however, transthoracic stump revision or window thoracostomy may be required. (Source: Thoracic Surgery Clinics)
Source: Thoracic Surgery Clinics - April 16, 2020 Category: Cardiovascular & Thoracic Surgery Authors: James M. Clark, David T. Cooke, Lisa M. Brown Source Type: research

How emergency physicians choose chest tube size for traumatic pneumothorax or hemothorax: a comparison between 28Fr and smaller tube.
This study aimed to investigate how emergency physicians choose chest tube size and whether chest tube size affects patient outcome. We reviewed medical charts of patients who underwent chest tube insertion for chest trauma within 24 hours of admission in this retrospective, single-institution study. Patient characteristics, inserted tube size, risk of additional tube, and complications were evaluated. Eighty-six chest tubes were placed in 64 patients. Sixty-seven tubes were placed initially, and 19 additionally, which was significantly smaller than the initial tube. Initial tube size was 28 Fr in 38 and
Source: Nagoya Journal of Medical Science - April 12, 2020 Category: International Medicine & Public Health Tags: Nagoya J Med Sci Source Type: research

A CARE-compliant article: a case report of pleural empyema secondary to Klebsiella pneumoniae liver abscess with a hepatopleural fistula
Conclusion: Pleural empyema is a rare but fatal complication secondary to KPLA. Additionally, the discovery of a hepatopleural fistula on a CT scan (multiplanar reconstruction image) made this case even more rare. Both, the liver abscess and pleural empyema, were effectively drained through the fistula tract with drainage procedure, thoracostomy, and additional liver abscess drainage. Prompt diagnostic evaluation, using an imaging modality such as CT, and early drainage management with intravenous antibiotics can improve clinical outcome. (Source: Medicine)
Source: Medicine - April 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Hemothorax resulting from an initially masked aortic perforation caused by penetration of the sharp edge of a fractured rib: A case report
ConclusionThis case suggests that even if great vessel injury is not detected on contrast CT at admission, it should always be considered especially in a hemothorax case with multiple rib fractures. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - February 14, 2020 Category: Surgery Source Type: research

Does simulation work? Monthly trauma simulation and procedural training are associated with decreased time to intervention
CONCLUSION High-complexity, routine procedural training, and trauma simulation are associated with decreased time to interventions within a short period of time. Routine implementation of a training program emphasizing efficient, effective approaches to bedside procedures is necessary to train our residents in these high-acuity, low-frequency situations. Future investigations are warranted in the effect of simulation on short-term and long-term patient outcomes. LEVEL OF EVIDENCE Therapeutic, level III. (Source: Journal of Trauma and Acute Care Surgery)
Source: Journal of Trauma and Acute Care Surgery - January 31, 2020 Category: Surgery Tags: AAST 2019 PODIUM PAPERS Source Type: research

A multicenter, prospective, controlled clinical trial of surgical stabilization of rib fractures in patients with severe, nonflail fracture patterns (Chest Wall Injury Society NONFLAIL)
BACKGROUND The efficacy of surgical stabilization of rib fracture (SSRF) in patients without flail chest has not been studied specifically. We hypothesized that SSRF improves outcomes among patients with displaced rib fractures in the absence of flail chest. METHODS Multicenter, prospective, controlled, clinical trial (12 centers) comparing SSRF within 72 hours to medical management. Inclusion criteria were three or more ipsilateral, severely displaced rib fractures without flail chest. The trial involved both randomized and observational arms at patient discretion. The primary outcome was the numeric pain score (NPS)...
Source: Journal of Trauma and Acute Care Surgery - January 31, 2020 Category: Surgery Tags: CWIS 2019 SUMMIT ARTICLE Source Type: research

Novel tube thoracostomy device reduces incision length
Chest tubes have historically been the intervention of choice for pleural drainage of blood, fluid, or air. Classic techniques may pose complications and have the potential to cause life-threatening injury [1]. The Reactor ® device, developed by Sharp pharmaceuticals, is a one-use plastic device that employs a retractable blade to cut through the subcutaneous tissue and enter the pleural space. Once the pleural cavity is entered, a catheter slides off the device and into the chest cavity. The chest tube is then place d through the catheter and subsequently attached to suction and secured. (Source: The American Journal ...
Source: The American Journal of Emergency Medicine - January 16, 2020 Category: Emergency Medicine Authors: Christopher Falslev, Shannon N. Thompson, Daniela Feldhausen Source Type: research

Pigtail Catheter Insertion Error: Root Cause Analysis and Recommendations for Patient Safety
Small-caliber chest tubes are used to treat pneumothorax and pleural fluid collections. Although commonly considered a less invasive alternative to large-caliber thoracostomy tubes, small-caliber tubes have a high complication rate. Emergency physicians must be familiar with common and dangerous procedure complications associated with these devices and have a systematic and rapid approach to identify and solve malfunctions. Structured root cause analysis can facilitate identification of problems. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - January 12, 2020 Category: Emergency Medicine Authors: Joshua S. Broder, Bahaadin Al-Jarani, Brenda Lanan, Kelli Brooks Tags: Techniques and Procedures Source Type: research

Needle Aspiration Versus Closed Thoracostomy in the Treatment of Spontaneous Pneumothorax: A Meta-analysis
ConclusionsFor the treatment of SP, NA method could significantly decrease complication rate, operation rate, as well as hospital stay length, compared with the CT method. Subgroup analysis indicated that the use of CT method in SSP and PSP patients might increase the initial success rate. (Source: Lung)
Source: Lung - January 10, 2020 Category: Respiratory Medicine Source Type: research

Clamping trials prior to thoracostomy tube removal and the need for subsequent invasive pleural drainage
ConclusionsA clamping trial prior to thoracostomy tube removal seems to be safe and was associated with less likelihood of a subsequent pleural drainage procedure. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - January 9, 2020 Category: Surgery Source Type: research

Pleural fluid glucose testing using a finger stick glucometer: a novel bedside test.
In this study, we compared the accuracy of B-PFG measurement to standard in-lab measurement (Lab-PFG). Methods: Patients undergoing thoracentesis or thoracostomy were enrolled. PFG was measured at the bedside with a finger stick blood glucometer (ACCU-CHEK® Inform II, Roche) and in the laboratory. Two consecutive measurements were taken using the glucometer, and their mean was compared to the glucose concentration measured in the laboratory. Pearson correlation coefficient and Bland-Altman Plot analysis were used to compare the two measurements. Results: Sixty patients were included. Mean age was 64.1 years. Fo...
Source: Journal of Thoracic Disease - January 8, 2020 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Clamping trials prior to thoracostomy tube removal and the need for subsequent invasive pleural drainage
Clamping trials —a brief period of clamping thoracostomy tubes prior to removal—may help reveal occult air leaks, minimizing the risk of needing a subsequent procedure to drain the pleural space. In this retrospective cohort study of patients with traumatic injury, clamping trials were associated with a reduced likelihood of a subsequent ipsilateral pleural drainage procedure within 30 days [adjusted OR 0.41 (95% CI 0.20–0.84)]. (Source: American Journal of Surgery)
Source: American Journal of Surgery - January 7, 2020 Category: Surgery Authors: James C. Becker, Scott A. Zakaluzny, Benjamin A. Keller, Joseph M. Galante, Garth H. Utter Source Type: research

Hemothorax: A Review of the Literature
Hemothorax is a collection of blood in the pleural cavity usually from traumatic injury. A chest x-ray has historically been the imaging modality of choice upon arrival to the hospital. The sensitivity and specificity of point-of-care ultrasound, specifically through the Extended Focal Assessment with Sonography in Trauma (eFAST) protocol has been significant enough to warrant inclusion in most Level 1 trauma centers as an adjunct to radiographs. If the size or severity of a hemothorax warrants intervention, tube thoracostomy has been and still remains the treatment of choice. Most cases of hemothorax will resolve with tub...
Source: Clinical Pulmonary Medicine - January 1, 2020 Category: Respiratory Medicine Tags: Critical Care/Respiratory Care Source Type: research

Silicosis with bilateral spontaneous pneumothorax in Rajasthan
Conclusions: Cases with silicosis can develop complications like tuberculosis, lung cancer, progressive massive fibrosis, cor pulmonale, broncholithiasis, or tracheobronchial compression by lymph nodes. Pleural involvement in silicosis is rare. Spontaneous pneumothorax is a pleural complication that can develop in such cases. Usually in silicosis pneumothorax is unilateral. We report here an original article with silicosis who presented with bilateral spontaneous pneumothoraxes occurring simultaneously. The rarity of its clinical presentation in the form of bilateral simultaneous spontaneous pneumothorax combined with the ...
Source: Indian Journal of Occupational and Environmental Medicine - December 15, 2019 Category: Occupational Health Authors: Manish Kumar Bairwa Nalin Joshi SP Agnihotri Source Type: research

Endovascular Thoracic Aortic Repair for Catheter Associated Aortic Injury During Thoracostomy Tube Placement
Aortic injuries during non-aortic related procedures are rare but potentially catastrophic. Endovascular aortic repair has been described as a viable option in similar circumstances. However, most reports involve aortic injury from orthopaedic hardware after spine surgery or trocar injury during abdominal surgery. (Source: EJVES Extra)
Source: EJVES Extra - December 12, 2019 Category: Surgery Authors: Edvard Skripochnik, Ali Reza Sattari, Thomas V. Bilfinger, Apostolos K. Tassiopoulos, Mohsen Bannazadeh Tags: Case Report Source Type: research

Is routine chest radiography after ultrasonography-guided catheter thoracostomy necessary?
CONCLUSION: Routine use of chest radiography after tube thoracostomy did not significantly change patient management, which is concordant with recent guidelines. Instead, adverse clinical outcomes or procedural factors should guide investigations. PMID: 31788706 [PubMed - as supplied by publisher] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - December 1, 2019 Category: General Medicine Authors: Soon YQA, Tan KWA, Kumar L, Pua U Tags: Singapore Med J Source Type: research

Efficacy of a Novel Surgical Manikin for Simulating Emergency Surgical Procedures.
This study included 36 ATLS students and nine instructors (4:1 ratio). Tube thoracostomy, cricothyroidotomy, pericardiocentesis, and diagnostic peritoneal lavage were performed on all the three models. The participants then rated their satisfaction both after each activity and after the course. The porcine and TraumaMan models fared better than SurgeMan for all skills except pericardiocentesis. In the absence of ethical or financial constraints, 58 per cent of the students and 66 per cent of the instructors indicated preference for the porcine model. When ethical and financial factors were considered, no preference was evi...
Source: The American Surgeon - November 30, 2019 Category: Surgery Authors: Garcia DFV, Domingues CA, Collet E Silva FS, Mori ND, Brasel KJ, Kortbeek J, Ali J, Poggetti RS Tags: Am Surg Source Type: research

Helicopter Transport in Pediatric Trauma: A New Methodology Using Need for Surgeon Presence to Evaluate the Necessity of Air Transport
This study proposes Need for Surgeon Presence (NSP) matrix as an alternative method to assess appropriate utilization of HT of pediatric trauma patients directly from the scene of injury.MethodWe utilized the 2016 TQIP database. NSP was defined as having one or more of the following: intubation, transfusion, operation for hemorrhage control/craniotomy, vasopressors, interventional radiology, spinal cord injury, tube thoracostomy, emergency thoracotomy, intracranial pressure monitor, or pericardiocentesis. The outcome of interest was the presence or absence of a NSP indicator.ResultsThe NSP+ patients had a: longer LOS, GCS
Source: The American Journal of Surgery - November 29, 2019 Category: Surgery Source Type: research

Heimlich valve: from the view of the patient
Heimlich valve (HV) drainage system, described at 1965 from Henry Heimlich, is a oneway valve system used by thoracic surgeons in various conditions. So many studies have been described in the literature to demonstrate the effectiveness and usefulness of the method. Differently, our study was planned to evaluate HV system from the view of the patients.This prospective study included 50 patients who underwent tube thoracostomy with different indications since August 2016. All the patients were discharged from the hospital with HV system. Patients demographic data, primary disease, indication for drainage, operative history,...
Source: European Respiratory Journal - November 20, 2019 Category: Respiratory Medicine Authors: Yoldas, B., Samancılar, O., Gürsoy, S., Ücvet, A., Güvenc, E., Ünal, M. Tags: Thoracic surgery Source Type: research

Selective bronchography (SB) to confirm bronchopleural fistula (BPF) in patients with persistent air leaks
Bronchopleural fistula(BPF)requires different diagnostic methods to know its location, number and size for a correct treatment. The aim of our study is to compare the computed tomography scan(CT)results with the selective bronchograpy(SB)information in BPF.Retrospective study including SB between 03.2014-2.2019. We analysed patients factors, pathology, CT and SB results and final treatment.SB technique requires instilling 10cc of Yodohexol Omnipaque® through a radiopaque catheter Combicath® during fluoroscopy, under deep sedation with propofol. We have included 27 SB performed under suspicion of BPF in patients wit...
Source: European Respiratory Journal - November 20, 2019 Category: Respiratory Medicine Authors: Jaurrieta Largo, S., De Vega Sanchez, B., Disdier Vicente, C., Belver Blanco, M., Juarros Martinez, S. A., Roig Figueroa, V. Tags: Interventional pulmonology Source Type: research

Bronchial artery laceration and haemothorax complicating transbronchial needle aspiration
Haemothorax following an endobronchial ultrasound ‐guided guided transbronchial needle aspiration (EBUS‐TBNA) as a result of bronchial artery laceration resolved with small‐bore chest tube drainage. A 74 ‐year‐old woman presented with chest pain and dyspnoea following endobronchial ultrasound (EBUS)‐guided transbronchial needle aspiration (TBNA) for presumed malignancy. Computed tomography angiography revealed a left‐sided pleural effusion with hypertrophied and tortuous bronchial arteries ( BAs) with contrast blush into the left lung hilum. Tube thoracostomy and pleural fluid analysis confirmed the diagnosis...
Source: Respirology Case Reports - November 6, 2019 Category: Respiratory Medicine Authors: William Grier, Or Kalchiem ‐Dekel, Jean Jeudy, Van Holden, Ashutosh Sachdeva, Edward Pickering Tags: Case Report Source Type: research

Deterioration of chest wall depression causing congestive hepatopathy after an open thoracostomy window in a patient with pectus excavatum and tuberculosis empyema
AbstractA 27-year-old man with severe pectus excavatum, dextrocardia and spinal scoliosis underwent thoracoscopic pleural decortication due to failure of 1-month medical treatment for tuberculous empyema. One month after the pleural decortication, he again underwent open thoracostomy window for repetitive pleuro-cutaneous fistula with tuberculosis empyema. He was subsequently referred to our clinic for progressive dyspnea and bilateral leg edema 4  months after the open thoracostomy window. Evaluations revealed deterioration of the chest wall depression and further compression of the inferior vena cava, which were con...
Source: General Thoracic and Cardiovascular Surgery - November 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Operative Management of Thoracic Gunshot Wounds: More Aggressive Treatment Has Been Required over Time.
Abstract Our department has a database of thoracic gunshot wounds (GSWs), which has cataloged these injury patterns over the past five decades. Prevailing wisdom on the management of these injuries suggested operative treatment beyond tube thoracostomy is not commonly required. It was our clinical impression that the operative treatment required beyond chest tube placement has greatly increased over the past several decades, whereas the operative management of cardiac GSWs seemed to be increasingly infrequent events. To test these observations, we analyzed the treatment of GSWs to the chest and heart in four disti...
Source: The American Surgeon - October 31, 2019 Category: Surgery Authors: Miller KR, Benns MV, Bozeman MC, Franklin GA, Harbrecht BG, Nash NA, Smith JW, Smock WS, Richardson JD Tags: Am Surg Source Type: research

Comparative Evaluation of Chest Tube Insertion Site Dressings: A Randomized Controlled Trial.
CONCLUSIONS: Overall, the best type of dressing for promoting skin integrity and patient comfort was the silicone foam dressing. The results of this study may help identify best practices for dressing type and procedures among patients with chest tubes. PMID: 31676515 [PubMed - in process] (Source: American Journal of Critical Care)
Source: American Journal of Critical Care - October 31, 2019 Category: Nursing Authors: Wood MD, Powers J, Rechter JL Tags: Am J Crit Care Source Type: research

Time Course of Hoist Operations by the Search and Rescue Helicopter Service in Southeast Norway
ConclusionsHoist rescue was performed in 10% (148) of the SAR operations. New information about hoist extrication time intervals can improve rescue helicopter dispatch accuracy. (Source: Wilderness and Environmental Medicine)
Source: Wilderness and Environmental Medicine - October 23, 2019 Category: Environmental Health Source Type: research

Is mediastinoscopy an effective diagnostic method in mediastinal area evaluation in pediatric patients?
CONCLUSION: Pediatric age mediastinoscopy may be the first method of diagnosis due to low complication rates and high diagnosis rates in mediastinal area. PMID: 31668417 [PubMed - as supplied by publisher] (Source: Asian Journal of Surgery)
Source: Asian Journal of Surgery - October 22, 2019 Category: Surgery Authors: Demir OF, Onal O Tags: Asian J Surg Source Type: research

Terrorist threat: creating a nationwide damage control training program for non-trauma care providers
Conclusions: The DC-TAV program is an ambitious, civilian-military, nationwide and long-term program, based on a harmonised standard of care and including multidimensional training. Further studies are required to assess its efficacy. (Source: Anaesthesia, Critical Care and Pain Medicine)
Source: Anaesthesia, Critical Care and Pain Medicine - October 13, 2019 Category: Anesthesiology Source Type: research

379 Novel Approach to Ultrasound Guided Thoracostomy (NoGUT)
Publication date: October 2019Source: Annals of Emergency Medicine, Volume 74, Issue 4, SupplementAuthor(s): L. Taylor (Source: Annals of Emergency Medicine)
Source: Annals of Emergency Medicine - October 10, 2019 Category: Emergency Medicine Source Type: research

Steroid therapy and outcome of parapneumonic pleural effusions (STOPPE): Study protocol for a multicenter, double-blinded, placebo-controlled randomized clinical trial
Discussion: STOPPE is the first trial to assess the efficacy and safety profile of systemic corticosteroids in adults with CAP and pleural effusions. This will inform future studies on feasibility and appropriate trial endpoints. Trial registration: ACTRN12618000947202 Protocol version: version 3.00/26.07.18 (Source: Medicine)
Source: Medicine - October 1, 2019 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Adequacy of hemostatic resuscitation improves therapeutic efficacy of recombinant activated factor VII and reduces reexploration rate for bleeding in postoperative cardiac surgery patients with refractory hemorrhage.
Conclusions: The therapeutic efficacy of rFVIIa is dependent on the adequacy of hemostatic resuscitation; restoration of normal serum fibrinogen, INR, and platelet counts>100 K/mL may provide an adequate substrate for rFVIIa to be effective in managing refractory postoperative cardiac surgical bleeding. PMID: 31621674 [PubMed - in process] (Source: Annals of Cardiac Anaesthesia)
Source: Annals of Cardiac Anaesthesia - September 30, 2019 Category: Anesthesiology Authors: Feih JT, Juul JJ, G Rinka JR, Baumann Kreuziger LM, Pagel PS, Tawil JN Tags: Ann Card Anaesth Source Type: research

Prehospital Needle Thoracostomy: What are the indications and is a post-trauma center arrival chest tube required?
ConclusionIn patients undergoing pNT, hypotension was rarely the indication. Additionally, CT identified the catheter within the pleural space in only 3 (5.8%) NT attempts. TT placement was performed in 79.3% of NT attempts. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - September 22, 2019 Category: Surgery Source Type: research