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At least 163 records · Page 9Linked to original sources
PubMed1993

Phosphatidylcholine-coated chest tubes improve drainage after open heart operation.

Occlusion of chest drainage tubes by thrombus is not uncommon after open heart operations. It has been suggested that by coating the tube with phosphatidylcholine (PC), the most prominent phospholipid in the erythrocytes outer membrane, it may be possible to overcome the blood-material interaction responsible for thrombus formation. To test this hypothesis 102 patients (75 males; mean age, 57 +/- 10 years) were randomly allocated to receive either PC-coated or noncoated 32F chest drainage tubes. Preoperative status, type and length of operation, and duration of drainage were similar in the two groups as was postoperative blood loss. Patients receiving PC-coated tubes, however, had less residual blood clot in the tube after removal (0.7 +/- 0.1 versus 3.1 +/- 0.3 g; p < 0.001), a reduced incidence of pericardial effusions (17.6% versus 41.2%; p < 0.01), fewer postoperative supraventricular arrhythmias (2 of 51 versus 10 of 51; p < 0.002), and a shorter hospital stay (8.4 +/- 0.3 versus 9.7 +/- 0.5 days; p < 0.05). Late cardiac tamponade developed in 2 patients in the noncoated group 6 and 10 days postoperatively, which required reexploration. The data show that PC-coated chest drainage tubes are less susceptible to occlusion by thrombus and their use is associated with a significant reduction in postoperative morbidity.

Aged↗
PubMed1984

Removal of chest tube using stomadhesive.

This simple method for removal of a chest tube allows a single operator to achieve a good seal upon completion of the maneuver. It has been a reliable and safe procedure in our hands. Patient tolerance of this uncomfortable procedure is enhanced by the rapid sealing and dressing of the wound in one step.

Carboxymethylcellulose Sodium↗
PubMed1999

Selective use of chest tubes in thoracotomies for congenital cardiovascular procedures.

BACKGROUND: Advantages and complications have been reported from the use of chest tubes (CT). To reduce the incidence of complications we have employed a selective use of CT in thoracotomy for congenital cardiovascular procedure; ie, in absence of air leaks and fluid to be drained, no CT was inserted. METHODS: The lung was reexpanded and air evacuated during the chest closure. Early and 6 hours chest roentgenograms were performed on every patient. This study retrospectively reviews the results of this selective approach in 546 patients operated on between 1980 and 1998 mainly for patent ductus arteriosum ligation, pulmonary artery band, aortic coarctation, Blalock-Taussig shunt. Four hundred and eighteen patients did not receive a CT at the initial surgery (group I), and 128 patients received a CT either before or at surgery (group II). RESULTS: 40 patients in group I developed an air or fluid collection large enough to require a CT. Only one patient had complication, from an undetected hemothorax. Nine patients in group II required another CT, and one patient developed a pneumothorax upon pulling out the CT. No death in either group was related to the use or lack of use of the CT. A total of 378 CTs and collecting chambers were saved. CONCLUSIONS: A selective approach to the use of CT in thoracotomies for cardiovascular procedures can be employed with minimal complications, more comfort for the patient, and cost savings.

Chest Tubes↗
PubMed2002

Chest tube management after pulmonary resection.

This article has provided a detailed description of the entire decision-making process of chest tube management. Although these protocols were derived from prospective randomized trials, further studies are needed.

Chest Tubes↗
PubMed2004

The use of methohexital during chest tube removal in neonates.

BACKGROUND: The aim of the study was the evaluation of the effect of methohexital during chest tube removal (CTR) in neonates. METHODS: Evaluation was based on the degree of sedation (grades 1-4) and relaxation (grades 1-4) and trends in vital signs heart rate, mean arterial blood pressure (MAP), oxygen saturation at time points (-10, -5, -3, -1, 0, 1, 3, 5, and 10 min) before and after administration of methohexital. A multidimensional pain scale [Leuven Neonatal Pain Scale (LNPS)] was used to evaluate pain expression. Effective sedation and relaxation (grade >2) would enable the physician to perform CTR without difficulties. Paired Wilcoxon was used to compare vital signs and pain expression before and after the procedure. RESULTS: Twenty-two procedures in 22 infants were recorded. Eleven infants were ventilated and 21 infants were having intravenous analgesics during CTR. Birth weight was 2645 g (range 1235-4500 g). Postnatal age was 6 days (range 1-80 days). Methohexital had no effect on ventilatory weaning, MAP or oxygen saturation. Heart rate increased from 144 (49) to 162 (43) (P = 0.012) b.min(-1). Sedation and relaxation were effective (>grade 2) and lasted for <5 min. No major side effects were documented. Adequate analgesia by LNPS was more difficult to evaluate as clinical pain evaluation was not feasible during full muscular relaxation. CONCLUSIONS: Administration of methohexital for CTR resulted in adequate sedation and relaxation without major side effects in neonates. This approach should be compared with other strategies.

Analgesics↗
PubMedDate not supplied

The chest tube: a simple device for the tunneling of central venous catheters.

The chest tube is presented as a device for the tunneling of central venous catheters. It offers several advantages over currently recommended tunneling devices. It is readily available in multiple sizes to accommodate different diameter catheters, produces lengthy atraumatic tunnels, and can be bent into various shapes to facilitate passage through the subcutaneous tissues.

Catheterization↗
PubMed1998

Perforation of the right ventricle: a complication of blind placement of a chest tube into the postpneumonectomy space.

We were asked to review a case from an outside hospital in which there was inadvertent perforation of the right ventricle during the percutaneous placement of a chest tube. We present the case in the hopes that by doing so, others will avoid such a complication in the future. After reviewing the case, it appeared that the complication occurred because the physician was not knowledgeable about the anatomy of the postpneumonectomy space and the physician failed to use the safest procedure in placing the tube.

Bronchiectasis↗
PubMedDate not supplied

Bone marrow sampling in pathologic fractures: intramedullary pediatric chest tube technique.

The objective of this article is to report upon a simple technique of bone marrow specimen collection of intramedullary bone tumors using a pediatric chest tube. This technique is described along with two case reports which include a 60-year-old female with metastatic breast cancer to the proximal femur, and a 63-year-old male with multiple myeloma of the proximal humerus. Utilizing this technique, in our experience, over 50 mL of aspirate can be obtained and definitive histologic material for cytogenetic diagnosis and immunohistochemistry. This technique is not indicated for biopsy of suspected primary lesions of bone due to the possibility of medullary or hematologic seeding and inappropriate invasion of soft tissue compartments.

Biopsy, Needle↗
PubMed1998

Mediastinal perforation and contralateral hemothorax by a chest tube.

Tube thoracostomy is an invasive and common procedure that is often life-saving, but by no means innocuous. We describe herein a case of chest trauma in which the chest tube crossed through the mediastinum between aorta and esophagus and penetrated the contralateral pleural cavity causing mild hemothorax. A literature search has failed to identify a similar case: the misplacement was detected in a control radiograph which led to early adjustment of the tube and no sequalae.

Aged↗
PubMed2005

A medical strategy to reduce persistent chest tube drainage after the fontan operation.

A standardized medical regimen aimed at reducing pleural effusions after the Fontan operation was compared with a randomly selected retrospective cohort. The duration of chest tube drainage, hospital stay, and the need for pleural sclerosis were significantly reduced, indicating that postoperative management plays an important role in reducing this morbidity.

Adult↗
PubMed1990

A new device that allows synchronous intermittent inspiratory chest tube occlusion with any mechanical ventilator.

Controlling a massively leaking bronchopleural fistula (BPF) can prove difficult. In combination with acute respiratory failure (ARF), BPF results in a mortality of 81 percent. Intermittent inspiratory chest tube occlusion (IICTO) is recognized as effective in controlling even the largest BPF; however, IICTO, as previously described, is difficult to use for a variety of reasons. We report two cases of BPF in association with ARF managed with a simple new device that allows the application of IICTO with virtually any mechanical ventilator. The effectiveness of the device and associated technique in controlling BPF leaks is clearly demonstrated and may have played a role in the eventual recovery of a patient with BPF. Further study of the technique is warranted.

Adult↗
PubMed1980

Pulmonary hemorrhage secondary to chest tube placement for pneumothorax in neonates.

We report two neonates in whom placement of a chest tube for pneumothorax was followed by hemorrhage, shock, and subsequent death. An autopsy of one of the patients led us to the conclusion that bleeding had occurred from lung perforation. The intercostal artery had been clearly severed and may have contributed to the hemorrhage. We discuss pathogenesis, diagnosis, and offer suggestions for proper placement of the tube.

Catheterization↗