PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Chest Tubes”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMed1999

[Idiopathic spontaneous pneumothorax: treatment by small-caliber catheter aspiration compared to drainage through a chest tube].

BACKGROUND: Several options are available for treating patients with a first episode of primary spontaneous pneumothorax (ISP). The aim of this study was to compare the efficacy of two treatment alternatives: puncture-aspiration (PA) using a small caliber catheter, and pleural drainage through a chest tube (DCT). PATIENTS AND METHODS: We compared a current series of 91 patients treated with PA with a retrospective series of 216 patients treated with DCT. PA was performed by emergency room physicians and DCT was performed by chest surgeons. Patients were followed for a period of 24 months. RESULTS: The immediate efficacy of PA was superior to DCT (86.7% versus 76%, p < 0.05). The proportion of recurrences after each treatment was similar (23% and 17%, respectively, NS). Duration of hospital stay was shorter for PA-treated patients (24 h) than for DCT-treated patients (138 h) (p < 0.05). The efficacy of the two procedures 24 months later was similar (63.7% and 62.9%, respectively, NS), and the cost of PA was three times less than that of DCT. CONCLUSIONS: PA is as effective a treatment procedure as DCT. PA is simple enough for emergency room physicians to perform correctly. Inconvenience to the patient, cost to the health care system, and time of hospital stay are all significantly less with PA.

Adult↗
PubMedDate not supplied

Comparison of two pain-management strategies during chest tube removal: relaxation exercise with opioids and opioids alone.

PURPOSE: The purpose of this study was to determine whether the use of a slow deep-breathing relaxation exercise, when used as an adjunct to opioid analgesia, decreases pain during chest tube removal (CTR) after coronary bypass surgery. DESIGN: A two-group quasi-experimental pretest/posttest design was used. SAMPLE: A convenience sample of 40 adults who had undergone coronary artery bypass graft surgery and met all inclusion criteria were recruited before CTR. SETTING: Data were collected in the Cardiothoracic Surgical Intensive Care Units of three acute care facilities in the Midwestern United States. METHOD: A 10-cm vertical Visual Analog Scale was used to measure pain at three points: before CTR, immediately after CTR, and 15 minutes after CTR. The experimental group received slow breathing relaxation exercises in addition to the usual opioid doses administered. FINDINGS: Data were analyzed using analysis of variance, and multivariate analysis of covariance yielded a significant difference in pain ratings immediately after CTR and 15 minutes after CTR for the group receiving relaxation exercise as an adjunct to opioid analgesic. CONCLUSIONS: This study supports the use of a slow deep-breathing relaxation exercise as an adjunct to the use of opioids for pain management during CTR among patients who have undergone coronary bypass surgery.

Adult↗
PubMed1999

Chest wall arteriovenous fistula: an unusual complication after chest tube placement.

Posttraumatic arteriovenous fistulas can form between vessels of the thorax that have sustained loss of integrity to the vessel wall. Although most are caused by injuries as a consequence of missile penetration or stab wounds, iatrogenic damage is a potential cause. Herein we present a case of a systemic arteriovenous fistula involving an intercostal artery and subcutaneous vein after chest tube placement.

Arteriovenous Fistula↗
PubMedDate not supplied

Intermittent inspiratory chest tube occlusion to limit bronchopleural cutaneous airleaks.

A significant bronchopleural cutaneous fistula (BPCF) developed in a 36-year-old female who required mechanical ventilation for acute respiratory failure. Progressive increase in arterial PCO2 to 75 torr occurred because of inability to effect satisfactory alveolar ventilation. Insertion of unidirectional values into the chest tube drainage apparatus, which were closed synchronously each time the ventilator cycled to the inspiratory phase, allowed effective alveolar ventilation to be achieved with subsequent reduction of arterial CO2 to previous levels. Both high inspiratory (120 torr) and expiratory (23 torr) positive pressures were employed with intermittent mandatory ventilation (IMV). Deleterious effects on cardiopulmonary function were not observed, and the patient was weaned successfully from mechanical support with spontaneous closure of the BPCFs.

Adult↗
PubMed1992

[Four cases of spontaneous pneumothorax with no reexpansion of collapsed lung despite chest tube drainage].

We report four cases of spontaneous pneumothorax with no reexpansion of the collapsed lung despite chest tube placement and adequate suction. The cause of absence of reexpansion was endobronchial obstruction by bronchogenic carcinoma in one patient and by sputum plug in another. In the other two patients, the collapsed lung had pulmonary fibrosis and did not reexpand at all because of reduced pulmonary compliance.

Adult↗
PubMed1994

Pleural effusions: outpatient management with pigtail catheter chest tubes.

Pulmonary effusions associated with ovarian cancer indicate advanced disease. Although many patients tolerate these effusions, some are symptomatic and manifest respiratory distress. Therapeutic sclerosis of the pleural cavity is successful in some patients; however, not all patients are relieved of respiratory symptoms. We present two symptomatic patients in whom sclerosis was unsuccessful or not an option; their respiratory symptoms were relieved with placement of pigtail catheter chest tubes that allowed discharge from the hospital and management at home. Catheters were easy to manage at home and there were no infectious complications.

Aged↗
PubMed2005

Life-threatening left lung collapse combined with mediastinal shift rescued by a chest tube insertion--a case report.

Pulmonary atelectasis due to acute endobronchial blood clot impaction is not uncommon in the setting of substantial hemoptysis. Sometimes, life-threatening hypoxemia and hemodynamic changes may occur even with collapse of only one lung. Alterations of pulmonary blood flow distribution with increased pulmonary shunt could contribute to these events. In addition, abnormal negative pleural pressure caused by total lung collapse also plays an important role in these situations. Here we report a case with near-fatal left lung collapse was rescued by immediate chest tube insertion. We would like to discuss the relative pathophysiology of the condition and anesthetic management of patient in such a dangerous situation.

Adult↗
PubMed1985

Unusual position of a chest tube with elevation of the contralateral hemidiaphragm.

We present a patient with emphysema and a right-sided pneumothorax in whom a chest tube was inadvertently positioned in the lower portion of the right major fissure. The tube migrated across the midsaggital plane, resulting in left shoulder pain with elevation of the left hemidiaphragm. Malfunctioning of the tube did not result, and following its removal the diaphragm returned to its original position.

Aged↗
PubMed2001

Intraoperative plateletpheresis and autologous platelet gel do not reduce chest tube drainage or allogeneic blood transfusion after reoperative coronary artery bypass graft.

Platelet-rich plasma (PRP) is postulated to decrease postoperative mediastinal chest tube drainage (MCTD) and allogeneic blood transfusions (ABT) after surgery with cardiopulmonary bypass. However, recent metaanalysis of the literature reveals that few good quality (therapeutic yield) trials that show a benefit have been published. The potential hemodynamic instability caused by plateletpheresis has not been emphasized. We studied the effect of plateletpheresis on MCTD, ABT, and hemodynamic stability in reoperative coronary artery bypass graft patients, a group perceived to be at high risk for ABT. Ninety patients were randomly assigned to Pheresis or Control groups. epsilon-Aminocaproic acid was given to all patients. Hemodynamic instability was assessed by degree of volume and inotrope resuscitation required. Part of the sequestered platelet volume was used to make autologous platelet gel, which was applied as a wound sealant. Mean pheresis yield was 30% +/- 7% of the circulating platelet mass or 6.4 +/- 2.2 allogeneic platelet unit equivalents. Total MCTD did not differ between the groups. There were no differences in mean packed red blood cell, platelet, and plasma transfusion rates. Overall, 52% of the Pheresis group received ABT, versus 55% of the Control group. Fifty-three percent of the Pheresis group patients exhibited significant hemodynamic instability, versus 27% of the Control group (P < 0.05). This study was unable to show any reduction in MCTD or ABT, although the plateletpheresis technique may offset platelet dysfunction caused by aspirin or increased blood exposure to nonbiologic surfaces, or it may compensate for lack of antifibrinolytic use. The significantly increased incidence of hemodynamic instability in the Pheresis group means that the risk/benefit ratio must be determined for individual cardiac surgical units.

Aged↗
PubMed1984

Lung perforation by chest tubes in the neonate.

In 272 consecutive neonatal autopsies in one institution, 70 patients had had intercostal drainage tubes inserted to treat air leak secondary to pulmonary disease. In 9 of these cases, one or more chest tubes penetrated lung parenchyma. The majority of these occurred in infants less than 36 weeks' gestation with hyaline membrane disease and its sequelae. Laceration of lung parenchyma most commonly occurred when tubes were inserted on the left side at 5 days or later and when multiple tubes were inserted.

Drainage↗
PubMed1984

CT- and ultrasound-guided catheter drainage of empyemas after chest-tube failure.

CT- and ultrasound-guided catheters were used to locate and drain empyemas in 17 patients, most of whom had failed to improve with conventional chest-tube drainage due to a poorly positioned tube. Fifteen patients (88.2%) were treated successfully, averting surgery or further drainage, and bacteremia in 1 patient was the only complication. Previously unrecognized communications with the bronchi, esophagus, and subphrenic space were demonstrated, and intracavitary tumor biopsy and instillation of a sclerosing agent were performed in several patients. Compared to the tubes used to drain abdominal abscesses, empyema catheters need less irrigation; dionosil is often the preferred contrast agent, the catheter can be withdrawn in one step, and a residual fibrotic or tumor cavity may persist after pus has been evacuated.

Adult↗