scholarly journals Serial Haemodynamic Change In Children With Acute Empyema

2004 ◽  
Vol 43 (152) ◽  
pp. 67-70
Author(s):  
Virendra Kumar ◽  
G Unikrishnan ◽  
R Anand ◽  
R Rathore ◽  
G Sethy
Keyword(s):  
Chest Tube ◽  
Tube Placement ◽  
Empyema Thoracis ◽  
Haemodynamic Change ◽  
Hemodynamic Changes ◽  
Hemodynamic Compromise ◽  
Moderate Disease ◽  
Haemodynamic Changes ◽  
Acute Empyema ◽  
Low Serum

Empyema thoracis continues to remain a serious complication of Pneumonia in children. A number ofstudies are available on demographics, etiology and treatment of empyema but no useful information isavailable on hemodynamic changes occurring in response to acute empyema. Therefore we aimed to evaluatethe serial haemodynamic changes in children with acute empyema and their correlation with severity andout come of the disease.Serial haemodynamic changes were studied prospectively in 25 children with acute empyema before andafter the placement of chest tube and subsequently on day 1, 2, 3 and 10 of hospitalization. Twenty-five ageand sex matched children served as their controls.Their age ranged from 8 months to 12 years (mean 4.2 years). Severity of empyema was graded as mild,moderate and severe in 11, 6 and 8 children respectively. Staphylococcus aureus was the commonestorganism isolated in 11 children. At admission all the children were febrile (mean temp 39.4C) hadtachycardia (mean HR136/mt) and tachypnea (mean RR 62/mt).While CVP was high (10.2? 4cm H2O), thesystolic (102 ? 4mmHg) and mean arterial pressure(77? 3mmHg) was at lower side as compared to theircontrols.The mean changes observed after the chest tube placement were HR- 6/mt; RR - 4.44/ mt; SBP+5mmHg; DBP +2.04mmHg; MAP +3mmHg and CVP-3.1cm H2o (p <.001). Children with severe diseasehad significantly higher CVP (15 ? 3.3cmH2o), low SBP (99 ? 3mmHg) and low serum Sodium (128? 5mEq/L) and Osmolality (278 ? 9 mOsm/L) compared to those with mild or moderate disease. (p<.05 foreach factor).Seven children had features suggestive of syndrome of inappropriate ADH secretion. All thischildren belonged to severe category.It was concluded that hemodynamic compromise is a common occurrence in children with empyema. HighCVP, low SBP, low serum Na+ and Osmolality correlate best with the severity of the disease.Key Words: Empyema, Hemodynamics, Children.

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.  

scholarly journals Optimal Initial Positioning of Chest Tubes to Prevent Retained Hemothorax Using a Novel Steerable Chest Tube With Extendable Infusion Cannula

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 324-330
Author(s):  
John B Fortune ◽  
Serena Murphy ◽  
Kimberley Tiller
Keyword(s):  
Chest Tube ◽  
Animal Studies ◽  
Training Session ◽  
Penetrating Trauma ◽  
Pleural Space ◽  
Tube Placement ◽  
Clot Lysis ◽  
Retained Hemothorax ◽  
Tip Position

ABSTRACT Introduction With blunt and penetrating trauma to the chest, warfighters and civilians frequently suffer from punctured lung (pneumothorax) and/or bleeding into the pleural space (hemothorax). Optimal management of this condition requires the rapid placement of a chest tube to evacuate as much of the blood and air as possible. Incomplete drainage of blood leading to retained hemothorax may be the result of the final tube tip position not being in contact with the blood collections. To address this problem, we sought to develop a “steerable” chest tube that could be accurately placed or repositioned into a specific desired position in the pleural space to assure optimal drainage. An integrated infusion cannula was added for the instillation of anticoagulants to maintain tube patency, thrombolytics for clot lysis, and analgesics for pain control if required. Materials and Methods A triple-lumen tube was designed to provide a channel for a pull-wire which was wound around an axle integrated into a small proximal handle and controlled by a ratcheted thumbwheel. Tension on the wire creates an arc on the tube that allows for positioning. In vitro testing focused on the relationship between the tension on the pull-wire and the resultant arc. Two adult cadavers and two anesthetized pigs were used to study the feasibility of accurate tube placement. After a brief training session, providers were asked to place tubes inferiorly along the diaphragm where blood was anticipated to accumulate or at the apex of the lung for pneumothorax. Success was determined with fluoroscopic images and was judged as a tube tip lying in the targeted position. Results The design was prototyped with an extruded polyvinyl chloride multilumen tube and a 3D printed tensioning handle. In vitro studies showed that one turn of the thumbwheel created 70° to 90° of arc of the tube. Cadaver and animal studies showed consistent success in the desired placement of the tube at or near the lateral diaphragm or in the apex. Attempts were also successful by surgical residents with minimal training. Conclusions Initial preliminary studies on a novel steerable chest tube have demonstrated the ability to appropriately position the tube in a desired location. The addition of an extendable cannula will allow for safe clot lysis or maintained tube patency. Additional studies are planned to confirm the benefit of this device in preventing retained hemothorax.

scholarly journals Comparison of non-intubated and intubated video-assisted thoracoscopic surgeries of major pulmonary resections for lung cancer—a meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Wenfei Xue ◽  
Guochen Duan ◽  
Xiaopeng Zhang ◽  
Hua Zhang ◽  
Qingtao Zhao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thoracic Surgery ◽  
Postoperative Complication ◽  
Complication Rate ◽  
Chest Tube ◽  
Meta Analysis ◽  
Tube Placement ◽  
Postoperative Complication Rate ◽  
Chest Tube Placement ◽  
Video Assisted

Abstract Objective The aim of this study was to compare the safety feasibility and safety feasibility of non-intubated (NIVATS) and intubated video-assisted thoracoscopic surgeries (IVATS) during major pulmonary resections. Methods A meta-analysis of eight studies was conducted to compare the real effects of two lobectomy or segmentectomy approaches during major pulmonary resections. Results Results showed that the patients using NIVATS had a greatly shorter hospital stay and chest-tube placement time (weighted mean difference (WMD): − 1.04 days; 95% CI − 1.50 to − 0.58; P < 0.01) WMD − 0.71 days; 95% confidence interval (CI), − 1.08 to − 0.34; P < 0.01, respectively) while compared to those with IVATS. There were no significant differences in postoperative complication rate, surgical duration, and the number of dissected lymph nodes. However, through the analysis of highly selected patients with lung cancer in early stage, the rate of postoperative complication in the NIVATS group was lower than that in the IVATS group [odds ratio (OR) 0.44; 95% CI 0.21–0.92; P = 0.03, I2 = 0%]. Conclusions Although the comparable postoperative complication rate was observed for major thoracic surgery in two surgical procedures, the NIVATS method could significantly shorten the hospitalized stay and chest-tube placement time compared with IVATS. Therefore, for highly selected patients, NIVATS is regarded as a safe and technically feasible procedure for major thoracic surgery. The assessment of the safety and feasibility for patients undergoing NIVATS needs further multi-center prospective clinical trials.

scholarly journals An alternative chest tube placement after uniportal video-assisted thoracic surgery

2018 ◽  
Vol 10 (5) ◽  
pp. 3078-3080
Author(s):  
Alessandro Palleschi ◽  
Paolo Mendogni ◽  
Alessio Vincenzo Mariolo ◽  
Mario Nosotti ◽  
Lorenzo Rosso
Keyword(s):  
Thoracic Surgery ◽  
Chest Tube ◽  
Tube Placement ◽  
Chest Tube Placement ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted

Uncommon complications during chest tube placement

2002 ◽  
Vol 28 (6) ◽  
pp. 812-813 ◽  
Author(s):  
Sophie M. Jaillard ◽  
Alain Tremblay ◽  
Massimo Conti ◽  
Alain J. Wurtz
Keyword(s):  
Chest Tube ◽  
Tube Placement ◽  
Chest Tube Placement

Effect of Intraparenchymal Blood Patch on Rates of Pneumothorax and Pneumothorax Requiring Chest Tube Placement After Percutaneous Lung Biopsy

2013 ◽  
Vol 200 (6) ◽  
pp. 1238-1243 ◽  
Author(s):  
LaDonna J. Malone ◽  
Robert M. Stanfill ◽  
Huaping Wang ◽  
Kevin M. Fahey ◽  
Raymond E. Bertino
Keyword(s):  
Chest Tube ◽  
Lung Biopsy ◽  
Tube Placement ◽  
Chest Tube Placement ◽  
Blood Patch ◽  
Percutaneous Lung Biopsy
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