scholarly journals Chest Tube Drainage Under Radiological Guidance for Pleural Effusion and Pneumothorax in a Tertiary Care University Teaching Hospital: Review of 51 Cases

2005 ◽  
Vol 12 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Luce Cantin ◽  
Carl Chartrand-Lefebvre ◽  
Luigi Lepanto ◽  
David Gianfelice ◽  
Antoine Rabbat ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Teaching Hospital ◽  
Chest Tube ◽  
Tertiary Care ◽  
Chest Tube Drainage ◽  
University Teaching ◽  
Tube Placement ◽  
Pigtail Catheter ◽  
First Line ◽  
Tube Drainage

BACKGROUND: Chest tube drainage under radiological guidance has been used with increasing frequency as a treatment option for pleural effusions and pneumothoraxes.OBJECTIVE: To evaluate the safety and usefulness of pleural drainage under radiological guidance for pleural effusion and pneumothorax in a tertiary care university teaching hospital.METHODS: A retrospective study of cases of chest tube placement under radiological guidance over a 12-month period in a university hospital.RESULTS: Fifty-one percutaneous pigtail catheter drainage cases were reviewed (30 patients). Forty-six (90%) chest tubes were inserted as a first-line treatment. The overall success rate of radiological drainage was 88%. Specific success rates were 92%, 85% and 91% for loculated pleural effusion, pneumothorax and empyema, respectively. The complications were few and minor.CONCLUSIONS: Pigtail catheter insertion under radiological guidance is a useful procedure for the treatment of sterile pleural effusion, empyema and pneumothorax. This technique can be used as a first-line procedure in the majority of cases.

Clinico-bacteriological Profile and Outcome of Empyema Thoracis in Children at a Tertiary Care Hospital of Central Nepal

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Atanu Pan ◽  
Debarshi Jana
Keyword(s):  
Ct Scan ◽  
Broad Spectrum ◽  
Chest Tube ◽  
Chest Tube Drainage ◽  
Diagnostic Tools ◽  
High Morbidity ◽  
Care Hospital ◽  
Empyema Thoracis ◽  
First Line ◽  
Tube Drainage

Background: Empyema thoracis (ET) is a serious infection of the pleural space. Despite the availability of broad spectrum antibacterial, improved vaccination coverage and better diagnostic tools, Empyema Thoracis remains associated with high morbidity worldwide. Delay   in   early   diagnosis,   failure   to institute   appropriate   antimicrobial   therapy,   multidrug resistant   organisms,   malnutrition,   comorbidities,   poor health  seeking  behaviour  and  high treatment  cost  burden contribute  to  increased  morbidity  in  children. The available  treatment  options  include  intravenous broad-spectrum antibiotics  either  alone  or  in  combination  with surgical  procedure  (thoracocentesis,  chest  tube  drainage, fibrinolytic  therapy,  decortications  with  video  assistedthoracoscopic surgery (VATS) and open drainage. Methods: Fifty Children between 1 month to 16 years admitted in the Pediatrics Ward, PICU of College of Medical Sciences, Bharatpur,Nepal. Data analysis was done by SPSS 24.0. Results: Present study found that according to blood culture, 3(6.0%) patients had enterococcus, 40(80.0%) patients had no growth, 2(4.0%) patients had pseudomonas, 4(8.0%) patients had staphylococcus and 1(2.0%) patients had streptococcus. We found that 20(40.0%) patients had done CT scan thorax, 30(60.0%) patients had not done CT scan thorax and 32(64.0%) patients had Amoxiclav first line antibiotic and 18(36.0%) patients had Ceftriaxone first line antibiotic. Conclusions: Suitable antibiotics and prompt chest tube drainage is an effective method of treatment of childhood empyema, especially in resource-poor settings. Majority of the patients progress on this conservative management and have good recovery on follow up.  

Intrapleural Alteplase in a Patient with Complicated Pleural Effusion

2003 ◽  
Vol 37 (3) ◽  
pp. 376-379 ◽  
Author(s):  
Charlotte A Walker ◽  
Mary Beth Shirk ◽  
Marva M Tschampel ◽  
James A Visconti
Keyword(s):  
Pleural Effusion ◽  
Chest Tube ◽  
Pleural Cavity ◽  
Surgical Intervention ◽  
Chest Tube Drainage ◽  
Tube Drainage ◽  
X Ray ◽  
Case Summary ◽  
Chest X Ray ◽  
Intrapleural Administration

OBJECTIVE: To report the intrapleural use of alteplase in a patient diagnosed with complicated pleural effusion (CPE). CASE SUMMARY: A 62-year-old white woman admitted with respiratory distress and hypotension developed a right-sided multi-loculated pleural effusion. Thoracentesis and chest tube drainage were not successful in resolving the effusion. In an attempt to increase the drainage of the pleural effusion, alteplase 16 mg was administered into the pleural cavity via the chest tube on 6 consecutive days. As a result, the volume drained from the patient's chest tube increased, there was improvement on the chest X-ray, and she did not require surgical intervention. DISCUSSION: While streptokinase and urokinase have been shown to be useful adjuncts to chest tube drainage in the treatment of complicated pleural effusion and empyema, there have been no reports on the use of intrapleural alteplase. This report demonstrates that intrapleural administration of alteplase is a useful adjunct to tube drainage in resolving CPE. CONCLUSIONS: This patient's CPE resolved when intrapleural alteplase was used as an adjunct to chest tube drainage and antibiotics. Controlled trials need to be conducted to investigate fully the efficacy, dosing, and safety of intrapleural alteplase in the treatment of patients with CPE and empyema.

scholarly journals Implication of pigtail catheter vs chest tube drainage

2018 ◽  
Vol 5 (9) ◽  
pp. 3686
Author(s):  
Alaa Elsayed ◽  
Rayan Alkhalifa ◽  
Muhannad Alodayni ◽  
Rakan Alanazi ◽  
Lara Alkhelaiwy ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Chest Tube ◽  
The Other ◽  
Chest Tube Drainage ◽  
Complication Rates ◽  
Pigtail Catheter ◽  
Chest Tubes ◽  
Tube Drainage ◽  
Other Hand ◽  
Lower Complication

Pigtail catheters and chest tubes have long been used for drainage of pleural collections for many years. In thoracic surgery, each technique is preferred in certain conditions. Pigtail catheters have the advantages of being smaller in size, more flexible, less traumatic, easier in insertion, and are associated with lower complication rates. They are particularly effective in draining non-viscid and non-coagulable fluids. The main disadvantages are their ineffectiveness in draining thick fluids, their higher liability to clogging, kinking, and obstruction. Chest tubes, on the other hand, have larger diameters allowing faster and more efficacious drainage of thick fluids and hemothorax. However, they are more painful, more distorting to tissues, and have higher complications rates. The aim of this article is to provide a review on both systems, and to compare the reported safety, efficacy, and complications of each.

Chest tube drainage placement may not be a necessity in paediatric thoracoscopic surgery: a retrospective study

2021 ◽  
pp. 1-5
Author(s):  
Gang Zhang ◽  
Dandan Liu ◽  
Ruiming Kuang ◽  
Chun Cai ◽  
Xiao Li ◽  
...  
Keyword(s):  
Chest Tube ◽  
Thoracoscopic Surgery ◽  
Perioperative Complications ◽  
Chest Tube Drainage ◽  
Tube Placement ◽  
Tube Drainage ◽  
Video Assisted ◽  
Increased Risk ◽  
Psychological Acceptance ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objective: Chest tube drainage placement, a standard procedure in video-assisted thoracoscopic surgery, was reported to cause perioperative complications like pain and increased risk of infection. The present study was designed to evaluate the necessity of chest tube drainage inpaediatric thoracoscopic surgery. Methods: Thirty children admitted to our hospital from April 2018 to April 2020 were included in the current study and were grouped as the tube group (children receiving video-assisted thoracoscopic surgery with chest tube drainage) and the non-tube group (children receiving video-assisted thoracoscopic surgery without chest tube drainage). Laboratory hemogram index, length of hospitalisation, post-operative performance of involved children, and psychological acceptance of indicated therapy by guardians of the involved children were investigated. Results: Laboratory examination revealed that the mean corpuscular haemoglobin concentration in the non-tube group was significantly higher than that in the tube group on post-operative day 1 (p < 0.05). Children in the non-tube group had a shorter length of hospitalisation (7–9 days) than that of patients from the tube group. Additionally, the frequency of crying of children was decreased and psychological acceptance by patients’ guardians was improved in the non-tube group when compared with the tube group. Conclusion: This study showed that chest tube drainage placement may not be necessary in several cases of paediatric video-assisted thoracoscopic surgery. Rapid recovery with decreased perioperative complications in children operated by video-assisted thoracoscopic surgery without tube placement could also reduce the burden of the family and society both economically and psychologically.

Severe dengue with massive pleural effusion requiring urgent intercostal chest tube drainage: a case report

2012 ◽  
Vol 30 (2) ◽  
pp. 389.e1-389.e2 ◽  
Author(s):  
Afzal Azim ◽  
Jyoti N. Sahoo ◽  
Arvind K. Baronia ◽  
Mohan Gurjar ◽  
Ratendra K. Singh ◽  
...  
Keyword(s):  
Case Report ◽  
Pleural Effusion ◽  
Chest Tube ◽  
Chest Tube Drainage ◽  
Severe Dengue ◽  
Tube Drainage ◽  
Massive Pleural Effusion

scholarly journals PERSISTENT PLEURAL EFFUSION FOLLOWING CARDIAC SURGERY SUCCESSFULLY TREATED WITH CHEST TUBE DRAINAGE: A CASE REPORT

CHEST Journal ◽  
2020 ◽  
Vol 157 (6) ◽  
pp. A196
Author(s):  
F. Olmati ◽  
A. Iacovelli ◽  
C.D. Evangelista ◽  
D. Moschetta ◽  
P. Palange
Keyword(s):  
Cardiac Surgery ◽  
Case Report ◽  
Pleural Effusion ◽  
Chest Tube ◽  
Chest Tube Drainage ◽  
Tube Drainage

scholarly journals Clinical profile, complications, morbidity and outcome of empyema thoracis in children in a tertiary care centre

2018 ◽  
Vol 5 (3) ◽  
pp. 967 ◽  
Author(s):  
Neha Agarwal ◽  
Sunil Taneja ◽  
Rachit Saxena ◽  
Ashish Verma
Keyword(s):  
Pleural Fluid ◽  
Conservative Management ◽  
Chest Tube ◽  
Bacterial Pneumonia ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Chest Tube Drainage ◽  
Care Hospital ◽  
Empyema Thoracis ◽  
Tube Drainage

Background: Empyema thoracis, an accumulation of pus in pleural space, occurs in 5-10% of children with bacterial pneumonia. Often cases are referred to the tertiary care hospital late resulting in significant complications, morbidity and mortality. Our aim was to study the clinical profile, associated complications, morbidity and treatment outcome of empyema in children.Methods: A prospective observational study was conducted on 65 children aged 0-12 yrs diagnosed with empyema thoracis admitted in the hospital. After history taking and clinical examination, relevant investigations like chest X-ray, USG chest and pleural fluid analysis including culture and sensitivity were done. All patients were treated with chest tube drainage, antibiotics and intrapleural fibrinolytic therapy.Results: Maximum patients (61.5%) were seen in age group 1-5 yrs, 18.4% below 1 year, 2 were neonates. Pleural fluid culture was positive in 64.6 % of patients. Staphylococcus aureus (58.4%) was the most frequent organism isolated from pleural fluid. Pyopneumothorax (36.9%), broncho-pleural fistula (27.6%) and pneumothorax (18.4%) were common complications. Broncho-pleural fistula was present at admission in 14 patients, developed later in 4 patients and healed with conservative management in 12 patients. Majority of the patients (n=51, 78.4%) had complete resolution of empyema thoracis with re-expansion of lung on conservative management alone. The success rate of medical management in patients who received intrapleural fibrinolytic (streptokinase) within 14 days of symptom onset was 93.3% while it was 71.4% in patients who received intrapleural fibrinolytic after 14 days. 5 (7.6%) patients died, 5 required surgical intervention(decortication/VATS), 4 patients with broncho-pleural fistula not improving on conservative management were referred to higher centre and were lost to follow-up.Conclusions: Empyema in children causes significant morbidity which can be reduced by prompt and adequate treatment of bacterial pneumonia. Antibiotics, chest tube drainage along with intrapleural fibrinolytic therapy is a safe and effective method to facilitate drainage and resolution of empyema even in cases with delayed presentation in resource poor settings and can reduce the need for surgery.

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