scholarly journals Spontaneous Tuberculosis-Associated Tension Pneumothorax: A Case Report and Literature Review

2020 ◽  
Vol 3 (2) ◽  
pp. 35-39
Author(s):  
Aditya Doni Pradana
Keyword(s):  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Tension Pneumothorax ◽  
Initial Assessment ◽  
Tube Insertion ◽  
Chest Tube Insertion ◽  
Hemodynamic Deterioration ◽  
Threatening Condition ◽  
Life Threatening ◽  
Needle Decompression

Secondary spontaneous pneumothorax (SSP) is one of the major complications of pulmonary tuberculosis (TB), and it can be a life-threatening condition if it progresses to tension pneumothorax. A correct initial assessment and prompt intervention will prevent a hemodynamic deterioration in tension pneumothorax. Needle decompression followed by large-bore chest tube insertion is usually required in the management of SSP. We present a case of spontaneous TB-associated tension pneumothorax in a young adult which resolved with needle decompression without chest tube insertion.

scholarly journals Where is the chest tube? Ectopic chest tube

2020 ◽  
pp. 102490792098126
Author(s):  
Syed Abdul Kader Mohamed Saleem ◽  
Ismail Mohd Saiboon ◽  
Muhammad’ Abid Amir
Keyword(s):  
Chest Tube ◽  
Flail Chest ◽  
Tension Pneumothorax ◽  
Emergency Setting ◽  
Tube Insertion ◽  
Common Procedure ◽  
Chest Tube Insertion ◽  
Iatrogenic Complications ◽  
Threatening Condition ◽  
Life Threatening

Tension pneumothorax is one of the commonest life-threatening condition seen in multiple injury or polytrauma trauma victims. Chest tube insertion has been the mainstay treatment for tension pneumothorax since early 1970s until today. Despite being a common procedure performed by an emergency resident, the incidence of complications related to the procedure remains significantly high. Iatrogenic complications are particularly more common in patients that are critically ill, obese or with a flail chest. This report will be discussing on an ectopic chest tube insertion during management of a case of traumatic tension pneumothorax in an obese patient with flail chest. Further discussions are on various recent updates on chest tube insertion procedures in an emergency setting. It is vital to understand that prior to chest tube insertion, it is important to acknowledge a possibility of complicated procedure by stratifying the risk of individual patients. Hence, this may reduce the risk of iatrogenic complications.

scholarly journals Bradycardia after Tube Thoracostomy for Spontaneous Pneumothorax

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Yomi Fashola ◽  
Sanjeev Kaul ◽  
Douglas Finefrock
Keyword(s):  
Elderly Patient ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Rare Complication ◽  
Tube Thoracostomy ◽  
Shortness Of Breath ◽  
Tube Insertion ◽  
Chest Tube Insertion ◽  
Severe Bradycardia ◽  
Life Threatening

We present the case of an elderly patient who became bradycardic after chest tube insertion for spontaneous pneumothorax. Arrhythmia is a rare complication of tube thoracostomy. Unlike other reported cases of chest tube induced arrhythmias, the bradycardia in our patient responded to resuscitative measures without removal or repositioning of the tube. Our patient, who had COPD, presented with shortness of breath due to spontaneous pneumothorax. Moments after tube insertion, patient developed severe bradycardia that responded to Atropine. In patients requiring chest tube insertion, it is important to be prepared to provide cardiopulmonary resuscitative therapy in case the patient develops a life-threatening arrhythmia.

scholarly journals Spontaneous Pneumothorax as a Complication of COVID-19 Pneumonia: A Case Report

2020 ◽  
Vol 4 (4) ◽  
pp. 521-523
Author(s):  
Leland Perice ◽  
Zhanna Roit ◽  
Ingrid Llovera ◽  
Mary Flanagan-Kundle
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Respiratory Symptoms ◽  
Tension Pneumothorax ◽  
Shortness Of Breath ◽  
Tube Insertion ◽  
Needle Decompression ◽  
Possible Cause

Introduction: Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2. It typically presents with respiratory symptoms such as fevers, cough, and shortness of breath. As the number of cases increases, however, COVID-19 is being increasingly recognized as being associated with a variety of other respiratory pathologies. Case Report: We present the case of a 59-year-old man with COVID-19 pneumonia who acutely decompensated after having been on the medicine floor for two weeks. He was found to have a tension pneumothorax. This was treated with a needle decompression followed by a chest tube insertion. The patient subsequently recovered and was discharged. Conclusion: This case highlights the importance of considering tension pneumothorax as a possible cause of shortness of breath in patients with COVID-19 pneumonia.

scholarly journals A Case of Chylothorax Causing to Chest Tube Insertion for Spontaneous Pneumothorax

2013 ◽  
Vol 9 (3) ◽  
pp. 156-159
Author(s):  
Hirotoshi Kubokura ◽  
Masami Otsuka ◽  
Junichi Okamoto ◽  
Jitsuo Usuda
Keyword(s):  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Tube Insertion ◽  
Chest Tube Insertion

European Pediatric Surgeons' Association Survey on the Management of Primary Spontaneous Pneumothorax in Children

2021 ◽  
Author(s):  
Tutku Soyer ◽  
Anne Dariel ◽  
Jens Dingemann ◽  
Leopoldo Martinez ◽  
Alessio Pini-Prato ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Chest Tube ◽  
Open Surgery ◽  
Spontaneous Pneumothorax ◽  
Primary Spontaneous Pneumothorax ◽  
First Episode ◽  
Tube Insertion ◽  
Recurrent Pneumothorax ◽  
Chest Tube Insertion ◽  
Pleural Abrasion

Abstract Aim To evaluate the practice patterns of the European Pediatric Surgeons' Association (EUPSA) members regarding the management of primary spontaneous pneumothorax (PSP) in children. Methods An online survey was distributed to all members of EUPSA. Results In total, 131 members from 44 countries participated in the survey. Interventional approach (78%) is the most common choice of treatment in the first episode, and most commonly, chest tube insertion (71%) is performed. In the case of a respiratory stable patient, 60% of the responders insert chest tubes if the pneumothorax is more than 2 cm. While 49% of surgeons prefer surgical intervention in the second episode, 42% still prefer chest tube insertion. Main indications for surgical treatment were the presence of bullae more than 2 cm (77%), and recurrent pneumothorax (76%). Eighty-four percent of surgeons prefer thoracoscopy and perform excision of bullae with safe margins (91%). To prevent recurrences, 54% of surgeons perform surgical pleurodesis with pleural abrasion (55%) and partial pleurectomy (22%). The responders who perform thoracoscopy use more surgical pleurodesis and prefer shorter chest tube duration than the surgeons performing open surgery (p < 0.05). Conclusion Most of the responders prefer chest tube insertion in the management of first episode of PSP and perform surgical treatment in the second episode in case of underlying bullae more than 2 cm and recurrent pneumothorax. The surgeons performing thoracoscopy use more surgical pleurodesis and prefer shorter chest tube duration than the responders performing open surgery. The development of evidence-based guidelines may help standardize care and improve outcomes in children with PSP.

Safety of the Anterior Approach Versus the Lateral Approach for Chest Tube Insertion by Residents Treating Spontaneous Pneumothorax: A Propensity Score Weighted Analysis

2019 ◽  
Author(s):  
Akihiro Shiroshita ◽  
Hiroki Matsui ◽  
Kazuki Yoshida ◽  
Atsushi Shiraishi ◽  
Yu Tanaka ◽  
...  
Keyword(s):  
Propensity Score ◽  
Chest Tube ◽  
Anterior Approach ◽  
Spontaneous Pneumothorax ◽  
Lateral Approach ◽  
Care Hospital ◽  
Tube Insertion ◽  
Chest Tube Insertion ◽  
Tube Malposition ◽  
Approach Group

Abstract Background Chest tube malposition (i.e., failure in inserting a chest tube to the functional sites) is the most common complication during chest tube insertion. Chest tube insertion into the thoracic cavity generally involves two approaches: the anterior approach and the lateral approach. To our knowledge, no report has compared the safety of the anterior approach with that of the lateral approach. In the present study, we compared the risk of chest tube malposition with the anterior or lateral approach for thoracostomy performed for patients with spontaneous pneumothorax by junior and senior residents. Methods We retrospectively included patients aged ≥20 years who exhibited primary or secondary spontaneous pneumothorax without pleural adhesion and underwent chest tube drainage performed by junior or senior residents at tertiary care hospital. We collected data on the patients’ age, sex, and body mass index (BMI); setting of chest tube insertion; department where the chest tube was inserted; and other relevant background information. The study exposure involved insertion of the chest tube in the midclavicular line (anterior approach) or the anterior or midaxillary line (lateral approach). The primary outcome was the number of chest tube malpositions. Multiple imputation was used for missing data. The propensity score within each imputed dataset was calculated by using the collected variables. The inverse probability of treatment weighting (IPTW) method was used to adjust for baseline confounders. Results We identified 34 and 219 patients who underwent thoracostomy using the midclavicular and lateral approaches, respectively. IPTW analysis revealed that the estimated odds ratio for chest tube malposition in the anterior approach group versus the lateral approach group was 0.61 (95% confidence interval, 0.17–2.11). Conclusions In patients being treated for primary or secondary pneumothorax by junior or senior residents, the risk of chest tube malposition in thoracostomies performed using the midclavicular approach may not be lower than that in thoracostomies performed using the lateral approach.

Symptomatic pneumorrhachis after chest tube insertion for spontaneous pneumothorax

2010 ◽  
Vol 28 (7) ◽  
pp. 846.e1-846.e2 ◽  
Author(s):  
Jung Soo Park ◽  
Hoon Kim ◽  
Suk Woo Lee ◽  
Jin Hong Min ◽  
Si Wook Kim ◽  
...  
Keyword(s):  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Tube Insertion ◽  
Chest Tube Insertion

scholarly journals Persistent air leak (bronchopleural fistula) in neonates

2021 ◽  
Vol 11 (3) ◽  
pp. 35-38
Author(s):  
Sunita Ojha ◽  
Goutam Sen ◽  
Rajiv Bansal ◽  
Anupam Chaturvedi ◽  
Mahaveer Saini
Keyword(s):  
Cardiac Arrest ◽  
Chest Tube ◽  
Case Reports ◽  
Bronchopleural Fistula ◽  
Tension Pneumothorax ◽  
Air Leak ◽  
Tube Insertion ◽  
Mortality And Morbidity ◽  
Chest Tube Insertion ◽  
Persistent Air Leak

Background: Pneumothorax is a known complication in neonates on ventilation but persistent air leak is infrequently seen in neonates and is troublesome to manage. Persistent air leak on chest tube insertion is suggestive of bronchopleural fistula, often resulting in significant mortality and morbidity. Various modalities of management like multiple chest tube insertions (thoracostomies), selective bronchial occlusion, pleurodesis using talc, tetracycline etc and urgent surgery to repair the leak have been mentioned. Islolated case reports for management of bronchopleural fistula in neonates are abound in literature but consensus and attention should be directed to improve awareness and access to clinical guidelines in management of bronchopleural fistula in neonates. Methods: Our aim was to evaluate the management and outcome of neonates with persistent air leak (bronchopleural fistula). Result: Eighteen neonates with bronchopleural fistula (BPF) were managed from 2012-2018. All neonates were managed by chest tube insertion, and slow suction (10-15cm of H2O). In those patients having persistent pneumothorax despite functioning tube with persistent air leak, second chest tube was inserted in 2nd intercostal space. Five of these patients even had cardiac arrest due to tension pneumothorax but were revived. One neonate required pleurodesis, two expired and remaining improved on multiple chest tube insertion and were discharged. None required selective bronchial intubation or surgery. Conclusion: Tension pneumothorax with persistent air leak on chest tube suggestive of Broncho-pleural fistula is a difficult and a rare problem in neonates. If not timely taken care of it can lead to cardiac arrest but despite cardiac arrest aggressive resuscitation and judicious use of multiple chest tube drainage and slow suction can help these little patients improve.

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